Objective: To evaluate the efficacy and safety of endovascular interventions for deep venous thrombosis (DVT) of the lower extremity with concomitant Cockett’s syndrome. Methods: The clinical data of 86 patients with lower extremity DVT and concomitant Cockett’s syndrome treated from June 2010 to June 2013 were retrospectively analyzed. The patients underwent thrombolysis by continuous micro-pump urokinase injection following the introduction of a thrombolytic catheter to the deep venous thrombus through an incision or puncture in the small saphenous vein at the lateral malleolus; at 7–10 days later, balloon dilatation alone or combined with stenting for the stenotic or occlusive segment of the iliac vein was performed, which was followed by anticoagulation, circulation-activation and compression stocking therapy, and continuous anticoagulation therapy with Warfarin or Rivaroxaban after discharge from hospital. Results: In the 86 patients, 22 cases received placement of inferior vena cava filter before thrombolysis due to acute pulmonary embolism or multiple floating thrombi in the iliofemoral vein and 5 of these 22 cases had placement of permanent filter; 35 cases underwent balloon dilatation only, and 51 cases had simultaneous stenting. After operation, the overall effective rate was 100%, no serious complications occurred, and only 4 cases presented mild bleeding complications during thrombolysis, which were resolved by adjustment of medication. Follow-up for 6 to 36 months was obtained in 82 patients, and the lumen patency rate was 91.46% (75/82), while intra-stent thrombosis or recurrence of deep vein thrombus occurred in 7 cases, which were eliminated by a repeat of catheter thrombolysis. Conclusion: Deep venous catheter thrombolysis combined with endovascular angioplasty is a safe, effective, and minimally invasive treatment for the lower extremity DVT with concomitant Cockett’s syndrome.