Aim: comparison between intraluminal and subintimal angioplasty with special emphasis on technique, factors affecting the success and complications. Methods: This is a prospective non randomized study included 159 patients presented over two yearsstarting from May 2014 to the vascular surgery department in Cairo University hospitals with critical chronic lower limb ischemia due to atherosclerotic femoropopliteal occlusive disease for whom percutaneous angioplasty was done. Patients presenting with non-salvageable limbs requiring primary major amputation and non atherosclerotic causes of CLI were excluded. Results: 75.5% of the lesions (120 cases) were crossed transluminally while 19.5% (31 cases) of the lesions were crossed subintimally. In 8 cases (5%) the lesion could not be passed. The overall technical success to pass the lesion was 95%. On 12 months follow up, 1ry patency, 2ry patency, limb salvage in intraluminal group are 56.8%, 60.2% and 66.1% respectively while in subintimal group 46.7%, 46.7% and 60% respectively. Subintimal was more in the TASC D , lesion more than 10 cm and in contralateral access ( P value was < 0.05). There was no stastistically signifacant differences between intraluminal and subintimal angioplasty regarding the outcome ( Patency and limb salvage). Conclusions: The passage of the wire is affected by length of the lesion, the TASC II classification of the lesion and access site with the subintimal passage was more in Lesion more than 10 cm, TASC D lesions and in contralateral access. These factors can be used prospectively as predictors for passage of the wire whether intraluminal or subintimal In spite of the technical differences between the intraluminal and subintimal passage , yet they show no significant statistical differences regarding the outcome (patency and limb salvage). Hence both should be used as part of vascular armamentarium for revascularization in such frail patients. Keywords: Critical limb ischemia; Limb salvage; femeropopliteal disease; subintimal angioplasty.