Objective: To investigate the clinical efficacy of hybrid procedures in treatment of acute limb ischemia (ALI). Methods: The clinical data of 43 patients with 46 ALI limbs undergoing combination treatment of conventional surgery and endovascular techniques between March 2011 and April 2014 were retrospectively analyzed. Results: The technical success rate was 97.7% (42/43), residual thrombosis rate was 7.0% (3/43), and the average ankle-brachial index after operation was 0.85±0.48. Nine patients (20.9%) developed osteofascial compartment syndrome and underwent open decompression, and during perioperative period, 3 patients (7.0%) underwent extremity amputation, one patient (2.3%) had toe amputation, and 3 patients (7.0%) died. One patient died of cerebral infarction 3 months after operation, and 35 patients were followed-up for more than 12 months, during which time, restenosis occurred in 2 cases who had popliteal artery stent placement. Conclusion: In the treatment of ALI, hybrid surgery shows high technical success rate and low residual thrombosis rate, thrombus removal and vascular reconstruction can be simultaneously conducted, and is worthy of clinical application.