Background : Popliteal artery occlusive disease is a common occurrence, especially in elderly patients, smokers, and those with diabetes mellitus and other cardiovascular diseases. Each year, more than 100,000 peripheral arterial reconstructive operations and 50,000 lower limb amputations for lower extremity limb ischemia are performed in the United States. Atherosclerosis is by far the most common cause of popliteal artery occlusive disease (Cynthia, Russell et al., 2008). Atherosclerotic disease isolated to the popliteal vessels is not common; however, popliteal artery occlusive disease as a result of systemic atherosclerosis associated with other lesions is extremely common. Popliteal artery occlusion is usually the end stage of a long-standing disease process of atheromatous plaque formation (Cynthia, Russell et al., 2008). It was found that below knee and retro articular popliteal arteries were more suitable for an endovascular procedure than above knee popliteal artery and had a better patency rate. Angioplasty of the femoropopliteal segment is acceptable, with best results at the distal two-thirds of the popliteal artery. This finding might be explained by a reduced mobility following knee flexion of the artery at this level compared with the upper popliteal artery (Abdul Raouf and Rouleau, et al., 2005).Patients and Methods: This is a prospective study including revascularization of50 cases of chronic atherosclerotic popliteal occlusive disease presenting to our institution along the period of one year (September 2010 to September 2011). No complex devices were used (e.g. outback catheter & atherectomy devices). Results: Our study included 50 cases, mean age of 62 years. Clinical presentation was claudications (4%), rest pain (22%) and tissue loss (74%). TASCB lesions were encountered in 12%, TASC C in 20% & TASC D in 74% of cases. The popliteal artery was involved in its upper, mid, & lower segment in41, 39 and 39 cases respectively. Successful revascularization was achieved in84% of cases and 6 months salvage rate was 75%. Amputation and mortality rate was 22 and 6% respectively. Conclusion: Revascularization of atherosclerotic popliteal occlusive lesion showed suboptimal results in TASC D especially in case of involvement of the mid popliteal or the crurals and in isolated segments or incomplete single vessel runoffs. Yet a larger series with a long term follow up is needed.