Introduction: Complex infrarenal aortic disease is rare. Short focal lesions are best treated by endovascular means, while long lesions are better treated surgically. The aim of the study is to evaluate the feasibility, patency and complications of endovascular management of complex aorto-iliac occlusive disease (AIOD). Patients and Methods: This is a prospective study of patients with complex AIOD presenting to Kasr Al-Ainy hospital in the period from June 2013 to June 2015. CT Angiography was performed in all patients to plan the procedure access and tools. All lesions were pre-dilated with an undersized balloon, and then were stented either by self-expandable stents, Balloon-expandable stents or covered stents according to our pre-study selection criteria. Technical success, Clinical success, Complications and follow up were reported. Results: Thirteen patients were included in this study. Eight cases had total occlusions (3 of them were Juxtarenal extending into the iliac bifurcation and 5 were at the distal aorta extending into the commom iliac artery(CIA). The other five cases had tight and long stenoses of the distal aorta extending into CIAs. We used 35 stents: 22 self expandable stents, 7 balloon-expandable stents and 6 covered stents. Technical success was achieved initially in all patients. One limb was amputated due to extensive pre-procedural infrainguinal disease. one patient died in the first postoperative day and another patient died 3 months later. Clinical success was achieved in the remaining 11 patients. Conclusion: Endovascular aortic revascularization shows promising early and midterm results. Initial results justify its use as a first choice. Large scale studies with longer follow up are awaited for to establish its role in the management of complex aorto-iliac disease in comparison to open surgery. Keywords: aortic occlusion - endovascular.