Objective: To investigate the clinical efficacy of integrated endovascular therapy for iliac vein compression syndrome (IVCS) with secondary deep vein thrombosis (DVT). Methods: From October 2004 to October 2012, 315 patients with IVCS and DVT were enrolled, with left leg involvement in 277 cases and right leg involvement in 38 cases. All patients underwent ipsilateral femoral vein puncture under local anesthesia, a 12- to 14-F sheath was inserted via a guidewire, and then mechanical thrombus aspiration or additional embolectomy with Fogarty balloon was performed, and the iliac vein stenosis or occlusion was treated with angioplasty or stent placement. Patients received anticoagulation therapy or/and catheter-directed thrombolysis after operation according to the degree of thrombus removal. Results: The swelling and pain in all the affected legs was alleviated 1-2 d after operation. Thrombus removal of grade III (removal rate greater than 95%) was 80.32%, grade II (removal rate between 50% and 95%) was 18.09%, and grade I (removal rate less than 50%) was 1.59%. The results of stent placement showed that 86.03% were excellent, 10.79% good, 2.54% improved and 0.64% unimproved. The differences between the leg circumference of the normal and affected extremities at 15 cm above and below the knee joint at time of discharge were all less than those at admission (both P<0.05). The follow up patency rate at 3-6 months was 95.87%, 7-12 months was 95.53%, 13-24 months was 94.25%, and 25-36 months was 92.33%, respectively. Conclusion: Integrated endovascular therapy for IVCS with DVT has demonstrable efficacy with fast recovery, so it is an effective and safe treatment method.