[Introduction] Adequate hemostasis of vascular access is important after invasive coronary procedures. Recently, vascular closure devices are commonly used due to the advantage of early ambulation. Total vascular occlusion is a rare complication of vascular closure device, and the incidence and clinical outcomes are not well known. [Method & Result] We investigated our consecutive patients(n=1,787), treated with vascular closure device from October 2004 to July 2006. During this period, 10 cases of total occlusion of femoral artery occurred(0.56%). Ten patients were all female of height 155.7짹15.4cm, weight 58.8짹20.2kg and BMI 24.4짹9.2 kg/m2. 7 patients underwent diagnostic CAG and the other 3, PCI. 4 patients used Angio-SealTM (0.94%) and 6 used PercloseTM(0.41%) and the incidence was not different between the 2 devices (p=0.32). The mean diameter of femoral artery was 4.0짹1.04 mm. 3 patients were punctured below the femoral artery bifurcation. In 9 patients, total occlusions of femoral artery were detected immediately after the procedure by checking the pulse of dorsalis pedis artery. Among them, 8 patients(89%) were successfully treated by percutaneous intervention; balloon angioplasty in 7 patients and stent implantation in 1 patient. One patient treated with PercloseTM had an emergent operation for removal of suture material due to the wire passage failure. Mean duration of hospital stay after the procedure was 5.8 days. In an exceptional case of a Marfan disease patient with severe aortic regurgitation who had used PercloseTM, the total occlusion occurred 18 days later due to delayed bleeding and recurrent infection. In this case, amputation was inevitable. Except for this case, patients treated immediately(n=9) did not show any change in the functional capacity and the degree of claudication compared to baseline during mean follow up of 6.4 months. [Conclusion] Vascular total occlusion after application of closing device is a rare, but occurred. Early detection and immediate treatment resulted in long-term good prognosis. Careful selection of candidate for closure device is mandatory and post-procedural distal pulse palpation should be performed for early detection of serious vascular complications.