Aim: To evaluate the effectiveness of angioplasty and stenting versus above-knee bypass in the treatment of symptomatic long segment superficial femoral artery lesions. Patients  & methods:  60 patients with symptoms of superficial femoral artery lesions P- 10 em long) were enrolled into the study. Thirty patients were randomly assigned to percutaneous transluminal angioplasty (PTA) and primary stenting. Another 30 patients underwent bypass surgery. All  patients in both groups  were followed  up at 1, 3, 6 and 12 months after either procedure. Results:  Patients who underwent endovascular treatment have got a primary patency rate 71.4% and a secondary patency rate 89.2%. Patients who underwentfem-pop bypass have got a primary patency rate 77. 7% and a secondary patency rate 81.4% at 12 months follow up. The primary & secondary patency rates among both groups were not significantly different (P= 0.754 & 0.451 respectively). Conclusion: Endovascular  treatment is an  effective  procedure  as bypass  surgery in the treatment of long superficial femoral artery lesions. It holds the advantages of short hospital stay and avoidances of surgery-related wound infection especially in diabetics.