Objective: To investigate the technical features and clinical efficacy of endovascular treatment of femoropopliteal arteriosclerosis obliterans in elderly patients. Methods: The clinical data of 50 elderly patients (62 limbs) with femoropopliteal arteriosclerosis obliterans undergoing endovascular treatment using percutaneous transluminal angioplasty (PTA) and stent implantation from March 2009 to January 2011 in our hospital were retrospectively analyzed. There were 30 male patients (38 limbs) and 20 female patients (24 limbs), whose ages ranged from 70 to 88 years (average of 78.5 years), and whose disease durations ranged from three months to five years. The lesions were located at femoropopliteal and infrapopliteal arteries. Results: Fifty-eight limbs were successfully treated and the technical success rate was 93.5% (58/62). Perioperative complications occurred in five patients that accounted for 8.06% (5/62), including one case of pseudoaneurysm formation at the puncture site, one case of artery perforation, two cases of artery dissection and one case of heart failure, which were all resolved after treatment. No perioperative deaths occurred. The ankle-brachial index (ABI) increased from 0.58±0.22 before surgery to 0.88±0.25 one week after surgery (t=7.09, P＜0.001). The primary patency rate was 80% (32/40) and 68.8% (22/32), and the secondary patency rate was 95.0% (34/40) and 75.0% (24/32) at 12 and 24 months after surgery, respectively. The limb salvage rate was 93.8% (30/32) at 24 months after surgery. Two patients underwent metatarsal-phalangeal amputation due to diabetic foot with necrotic toe. Conclusions: For the elderly patients with femoropopliteal arteriosclerosis obliterans, the endovascular treatment has better short-term effect, high technical success rate and low complication incidence. Rigorous perioperative management can prevent the occurrence of complications, and its long-term efficacy needs to be assessed by further follow-up.