Background: Critical limb ischemia is the natural endstage in many patients with atherosclerotic chronic lower limb ischemia. Most of these patients are risky for major surgical revascularization procedures. Infrapopliteal angioplasty can represent an alternative procedure to the popliteal to distal bypasses in such group  of patients. Aim of the study:  To evaluate the efficacy ofinfrapopliteal angioplasty in management of patients with critical  limb ischemia. Patients and methods: 48 limbs  in 47 patients with  critical limb ischemia, secondary to atherosclerosis involving the tibial vessels, underwent treatment with tibial angioplasty.Immediate technical success, sustained clinical improvement based on Rutherford upward categorical shift, and limb salvage rates were assessed and recorded. Results:  75% of involved  patients belonged to category 4-6 of Rutherford  classification. 63% had pure tibial disease and 37% had a concurrentfemoropopliteal multilevel disease. 92% of tibia/lesions were classified as TASC D lesions. Immediate technical success was recorded  in 44 limbs  (91.6%). Sustained clinical improvement and  limbs salvage rates were 100%, 92%, 84% and  77% at 1, 3, 6 and 12 months, respectively. Conclusion: Infrapopliteal angioplasty represents an effective method  in treating patients with critical/ower limb ischemia.