Introduction: Surgery for focal infrarenal aortic stenosis or occlusive aortoiliac lesions has been the traditional standard of care with good long-term patency rates. Numerous encouraging reports about endovascular revascularization, mainly by using bare metal stents, on TASC II class C and D aorto-iliac lesions were very promising regarding safety, mid-term durability. Objectives:This is a pilot study with the assumption of non-inferiority of covered stent endovascular reconstruction for focal infrarenal aortic and aortoiliac lesions to current endovascular bare metal stent therapy. Methods: Patients with aortic occlusive disease ranging from isolated focal infrarenal aortic stenosis to total occlusion of the infra-renal aorta extending or not to the iliac arteries were treated by covered stents during the period from January 2014 to December 2015. Our Exclusion criteria included: Patients with iliac occlusive diseases with no involvement of infra-renal aorta (bifurcation only), associated extensive infra-inguinal occlusive disease, chronic renal impairment and those with connective tissue disorders or history of previous endovascular intervention. Results: Seven patients met our inclusion criteria, six patients (85.7%) were men. Two patients had isolated mid infrarenal aortic focal stenosis (both were > 3 cm in length)without bifurcation involvement. One patient had rather focal near bifurcation stenosis with length ≤ 3cm. Four patients had chronic total aortobiiliac occlusion (TASC II D). Rest pain was the most common (57%), while minor tissue loss (2 patients) and severe claudication (1 patient) constitute the rest of patient's presentation. Preprocedural mean resting ABIs were 0.55 ± 0.15 at the right side and 0.59 ± 0.15 at the left side. In the three patients with focal stenosis of the aorta, mean aortic stenosis before the procedure was 70% (range, 60%- 80%). We used total of 15 stents with diameter range (8-12mm) and length range (41-61mm). Technical and immediate clinical success were achieved in all our patients (100%) as confirmed by palpable distal pulses, improvement of walking distance and absence of rest pain. Trophic changes were healed completely 3- 4 months after the procedure. The immediate hemodynamic results showed mean resting ABI to increase to 0.95± 0.05 on the right side and to 0.96 ± 0.04 on the left side. No deaths were observed in the first 30 days. During a mean follow up of 10.5 months (range, 9-12 months), five patients had their stented arterial segments patent (The primary patency rate at 3, 6 and 12 months were: 85%, 85% & 71% respectively). One patient developed significant instent stenosis in one iliac stent after 3 months and was treated balloon angioplasty using a drug coated balloon (DCB). Another patient, at 6 months follow up, developed symptom recurrence due to tight bilateral ostial stenosis at the new bifurcation following CERAB technique and was treated by kissing drug eluting stents (DES). At 12 months’ follow up no patient showed symptoms of limb ischemia or recurrence of trophic changes. Conclusion:Covered stent therapy for occlusive aortoiliac diseases is a technically feasible and potentially safe procedure that demonstrates very good early and mid-term patency. Based on the available data, covered stents may be considered the best and unavoidable technical solution in restoring blood flow through occluded infrarenal aorta and iliac arteries.