Background: For more than forty years, endarterectomy and bypass grafting have been the primary means of surgically revascularizing peripheral vessels threatened by atherosclerotic diseases. However, with today's endovascular technology, stenosis and occlusions in nearly every circulatory system can he approached intraluminally with balloon dilation and intravascular stents. Objective: To evaluate the technical success rates, primary patency, limb salvage, patient survival and complications for TASC C, and D iliac lesions treated by endovascular procedure. Additionally, the influence of the access site and the clinical outcomes were analyzed. Patients and Method: Between 2017 and 2019, data from 40 consecutive patients at Al-Zahra'a University Hospital and Damanhor Teaching Hospital with 47 chronic iliac artery stenosis, and/or occlusion who were treated with EVT were reviewed. Results: The procedure time was longer for TASC D lesions than for TASC C lesions (180.43 ± 45.97 VS131.69 ± 37.49: p= 0.001). There were two postoperative deaths in the TASC D lesion group, with the cause being one myocardial infarction, and one postoperative hospital acquired pneumonia. The total perioperative complication occurred in the TASC D lesions was [four (10%) vs. zero; p = 0.011] TASC C lesions. Corresponding 2-year primary patency rates were 100% in TASC C lesions, 71.4% in TASC D lesions, and for all cases were 87.5%. Conclusion: The outcomes of EVT for TASC C and D aorto-iliac lesions were acceptable, with better technical success in TASC C lesions than in TASC D lesions. The 2-year patency rate for both TASC C and TASC D lesions was acceptable, and brachial access was useful for complex anatomy.