Background: For almost 50 years, endovascular treatment has been used to treat chronic limb ischemia. The retrograde contralateral "crossover," antegrade ipsilateral, or retrograde popliteal techniques may be used to treat superficial femoral artery occlusions. There were early drawbacks to the retrograde technique, thus it was used as an emergency alternative. Objective: This study aimed to investigate efficacy and safety of ipsilateral retrograde balloon angioplasty for flush lesions of superficial arterial blockage. Patients and methods: This prospective cohort study was carried out at Sayed Galal Hospital and Al-Hussein Hospital through the period from August 2018 to August 2021.  This study included 50 individuals with peripheral arterial disease (PAD). Interventional study was conducted on flush lesions of superficial femoral artery occlusion. Results: A significant difference between patients who achieved patency and who did not achieve patency) regarding BMI, dyslipidemia, cardiac diseases and postoperative ABI).   Conclusion: Retrograde balloon angioplasty of flush lesions is a reliable procedure for superficial femoral artery occlusion handling with relatively low rate of complications.