Objective: To investigate the mid- and long-term results of endovascular-based procedures for Cockett syndrome. Methods: The clinical data of 412 patients with Cockett syndrome treated between January 2003 and February 2014 were retrospectively analyzed. In these patients, 231 cases were acute left iliac femoral vein thrombosis (group A), and 181 cases were chronic venous insufficiency (group B), and different endovascular procedures and/or hybrid procedures were performed. Results: In group A, the technique success rate was 100% (231/231); the left iliac vein in 5 patients showed no stenosis or occlusion, and the incidence of pathological changes in the left iliac vein was 97.8% (226/231); a total of 182 stents were implanted. In group B, the technique success rate was 99.4% (180/181); one patient developed a large retroperitoneal hematoma and hemorrhagic shock due to rupture of the left iliac vein during balloon-inflation angioplasty, and was resuscitated by aggressive efforts; the average pressure difference between the proximal and distal portion of the pathological left iliac veins decreased from preoperative (18±4.45) cmH2O to postoperative (4±3.02) cmH2O (P<0.01); 89 patients, complicated with valvular incompetence in the left superficial femoral vein, underwent a second-stage femoral valve repair. Follow-up ranged from 3 months to 8 years, with an average of 35.6 months, and intrastent thrombosis occurred in 15 cases of group A and in 2 cases of group B. Conclusion: Endovascular-based procedures offer favorable mid- and long-term results in treatment of Cockett syndrome, which in combination with Fogarty catheter thrombectomy or catheter-directed thrombolysis is a beneficial complementary treatment for those complicated with acute iliac femoral vein thrombosis.