Objective: To evaluate the effectiveness and safety of using catheter directed thrombolysis (CDT) technique in treatment of femoropopliteal long segment thrombotic occlusion. Methods: The clinical data of 71 patients with femoropopliteal long segment thrombotic occlusion undergoing CDT procedure from 2012 to 2016 were retrospectively analyzed. Results: CDT procedures were successfully performed in the whole group of 71 patients. The length of the target lesions ranged from 7 to 42 cm, with an average length of 28.2 cm, and the duration of continuous thrombolysis ranged from 6 to 168 h, with an average duration of 70.6 h. After CDT, complete thrombus removal was 74.6% (53/71), partial thrombus removal was 14.1% (10/71) and thrombolysis failure was 11.3% (8/71). No major bleeding occurred in the entire group of patients, the incidence of “trash foot” was 22.5% (16/71), and the incidence of arterial approach-related complications was 8.6% (6/71). One patient died of acute myocardial infarction after CDT procedure and one patient underwent a foot amputation. The plasma fibrinogen and the hemoglobin levels decreased more evidently in patients complicated with bleeding at the puncture site compared with those without bleeding at the puncture site (both P<0.05). Conclusion: CDT technique can effectively remove the thrombus, and is a safe and effective treatment method for femoropopliteal long segment thrombotic occlusion.