Iliofemoral deep venous thrombosis is frequently associated with irreversible damage to valvular competence of the veins and consequently with varying degrees of chronic venous insufficiency. Conservative treatment with heparin and oral anticoagulant, systemic thrombolysis and thrombectomy are possible therapies. Venous thrombectomy prevents late post-thrombotic sequel, venous reflux and preserves valvular function of the veins but this technique should be limited in case of failure or contraindication of thrombolysis or in phlegmasia cerulae dolens with impending venous gangrene.