Objective: To evaluate the clinical efficacy of hybrid procedure in treatment of multisegmental lower extremity arteriosclerosis obliterans (ASO) involving the femoral artery bifurcation. Methods: The data of 46 patients (47 limbs) with multisegmental lower extremity ASO involving the femoral artery bifurcation undergoing hybrid procedure from October 2010 to December 2014 were reviewed. The relevant clinical variables and the influence of the severity of disease and type of procedure on primary patency rate were analyzed. Results: The technical success rate was 98% (46/47), and no perioperative death occurred. The average ankle-brachial index was increased from the preoperative 0.34±0.16 to postoperative 0.69±0.11. The average follow-up time was 21.8 months with a follow-up rate of 93% (43/46), and the cumulative primary patency rate was 67.4%. Kaplan-Meier analysis showed that the primary patency rate was significantly decreased with the higher Fontaine stages of the diseased limb, and primary patency rate was significantly lower when the endovascular intervention was performed in both the proximal and distal segment of the vessel in the surgical area than when performed on only the proximal or distal segment of the vessel (all P<0.05). Conclusion: Hybrid procedure is an effective treatment modality for multisegmental lower extremity ASO involving the femoral artery bifurcation, and it also accords with the principle of individualized therapy.