Aim: To assess the efficacy of catheter directed thrombolysis in the management of acute iliofemoral deep venous thrombosis and its value as an initial management step. Patients & methods: 30 patients with acute iliofemoral deep venous thrombosis without contraindications for thrombolysis managed from April 2013 till April 2016, were included in the study. Patients underwent catheter directed thrombolysis of thrombosed iliofemoral veins within 14 days of occurrence, with or without concomitant stenting. The primary patency of this procedure was assessed and early and late reinterventions were reported. Results: Females were 56.7% (n=17). The anatomic success rate was 100 % (n=30), 1ry stenting was done in 36.6 % (n=11) of cases. The patency rate after 6 months and 1 year was 100 %. One case (3.3 %) of the stented iliac vein needed re-intervention after 18 months. Follow up ranged from 12 to 24 months (mean = 18). CDT was done for the left lower limb in 60% (n=18) of cases. 33 % (n=10) of patients had a hematoma at the site of entry and all were treated conservatively. There was no major systemic bleeding, symptomatic PE or deaths in our study group. Conclusion: Catheter directed thrombolysis is effective and safe and can be implemented as a primary choice in the management of iliofemoral deep venous thrombosis in carefully selected patients. Key-words: Thromolysis, DVT and Phlegmasia.