Background: Endovascular management of popliteal artery (PA) occlusive disease constitutes a territory of true challenge. PA comprises a milieu that have higher likelihood of de novo disease, challenging lesions, and amplified response to injury with overall implication on difficult recanalization, limited room for stenting and higher restenosis rate. Aim of study: To evaluate the outcome of percutaneous transluminal angioplasty (PTA) in recanalization of PA total occlusive lesions, its feasibility, safety, patency and complications. Patient and Method: Between October 2012 through December 2014, 21 patients with severe ischemia due to PA occlusive disease were included in this study. Rutherford ischemia class 4 was the main presentation in eight (38%) cases. Ischemic Heart Disease (IHD) was the main comorbidity in 20 (95%) cases. Distal reconstitution of one tibial vessel was present in 10 (47.6%) cases. Patients were followed up both clinically and by duplex ultrasound at one, six, and12 months. Results: The procedure was technically successful in 19 patients who had immediate angiographic success with restoration of distal pulsations in 13 patients. Failure to cross the lesion occurred in two cases. One patient had groin hematoma that required open surgical control and repair. Primary patency rates were 72.3%, 35.3%, and 21.4%, while limb salvage rates were 85.7% ,80.9% , and 66.7% at 1,6, and 12 months respectively. Conclusion: Although technically demanding, PTA can be considered as a feasible and safe option for revascularization of total occlusive lesions of the PA. The relatively mid-term low patency rates should not preclude the advantage of buying time for achieving limb salvage in poor s