Purpose: To assess long-term clinical outcomes associated with endovascular stenting as an alternative to surgery in the treatment of aortic total occlusion. Methods: Retrospective review of 32 patients with infrarenal aortic total occlusion who underwent endovascular treatment at our institution. Clinical characteristics, technical success and procedure related complications were evaluated. Results: Main presenting clinical symptoms were claudication and rest pain (75.1%). Main cause of total occlusion of aorta was atherosclerosis except 2 Takayasu���s arteritis. Technical success rates were 91% (29 out of 32 patients): technical failure in three patients was secondary to inability to pass the guidewire through the aorta. Periprocedural complications included 10 distal embolization events that were treated with a thrombolytic (Urokinase 200,000 IU) infusion; 1 renal artery jailing; 2 large hematomas; and 1 puncture-site pseudoaneurysm. There was one mortality from aortic rupture one day post-procedure. Follow up was done in 27 pateints (96.4%) and mean clinical follow-up duration was 46 짹 26 months. One patient was lost to follow-up and Clinical success rates with free of lifestyle-limiting claudication were 88.8% (24 out of 27 patients). Three patients required repeat intervention or bypass surgery. Conclusion: Endovascular treatment of total aortic occlusive lesions is associated with long-term safety and efficacy and therefore should be considered as first-line treatment.