Background : Subintimal angioplasty is gaining favor as a new interventional technique especially for treating long segment lower extremity arterial occlusions, however its value still remains in question. We investigated the feasibility and safety of subintimal angioplasty in chronic severe ischemic limbs. Methods : During a 3-month period, subintimal angioplasty was attempted in 14 limbs of 13 patients (12 males, age 64.3짹11.3 years). Six patients had pedal ulcer (Fontaine class IV) and seven severe claudication of <200 m (class IIb). Most patient had comorbidities such as hypertension (n=9), DM (n=9) or CAD (n=8). All patients had multi-segmental arterial obstructive lesions of lower limbs. All target lesions were chronic occlusions of 21.5짹7.6 cm length (9 superficial femoral, 4 superficial-femoral-popliteal, and 1 iliac artery lesions). Angioplasty was performed via antegrade ipsilateral or retrograde contralateral common femoral artery puncture. Results : Subintimal angioplasty was successful in 13 of 14 limbs (92.9%). One procedural failure was from an inability to reenter the patent distal lumen. There was no procedure-related complications requiring surgery. Self-expandable nitinol stents (diameter 7.9짹1.0 mm, length 75.3짹17.6 mm) were implanted in 13 lesions (1.38짹0,77 stents/lesion). The residual pressure gradient over the treated segment was 7.1짹5.9 mmHg. Post-procedural ankle-brachial index rose from 0.43짹0.19 at baseline to 0.70짹0.17. Conclusion : Subintimal angioplasty was feasible and safe and achieved favorable early results for revascularization of long segment lower limb artery occlusions. Long-term follow-up is needed to prove its efficacy.