Objective: To investigate the efficacy of endovascular atherectomy in treatment of femoropopliteal artery stenosis with outflow obstruction. Methods: From July 2014 to June 2015, 21 patients who had femoropopliteal artery stenosis with distal outflow tract obstruction and severe intermittent claudication as the main symptom underwent endovascular atherectomy, and then they were followed up. Results: Compared with preoperative findings, the claudication distances of the patients at 3, 6 and 12 months after operation were all significantly increased with a rising trend (all P<0.05), and the ankle-brachial indexes of the patients on 2 d, and at 3, 6 and 12 months after operation were all significantly increased (all P<0.05). Restenosis of the target vessel did not occur in any of the patients at 3 months after operation, but occurred in one case (1/21) 6 months after operation and in 2 cases (2/21) at 12 months after operation, and all stenoses were of a moderate degree. Conclusion: Endovascular atherectomy offers a satisfactory short-term efficacy in treatment of femoropopliteal artery stenosis with outflow obstruction.