Introduction: Iliac and common femoral artery occlusive disease (IFOD) can often manifest in a debilitating condition for patients and be challenging to manage. Endarterectomy with patch angioplasty is the standard for treatment of isolated common femoral artery (CFA) occlusive disease. However, the management of disease that extends proximally into the iliac arteries is a more challenging problem. In the endovascular era, endoluminal treatment has been shown in certain situations to be a comparable option for iliac occlusive disease. However, it is not a suitable stand-alone therapy in the presence of significant CFA disease. In the presence of severe IFOD, hybrid repair (HR) combining endovascular iliac stenting and common femoral endarterectomy, may represent an alternative to open aortoiliofemoral surgical reconstruction. The main advantage of hybrid procedures is the ability to treat more complex anatomy by less invasive procedures in patients considered at high medical risk. Aim: The purpose of this study was to review our contemporary experience in treating severe chronic iliofemoral occlusive disease (IFOD) with hybrid repair (HR). Particular attention was given to periprocedural safety, technical outcomes, and procedural durability. Patients and methods: Between July 2010, and July 2014, 32 Common Femoral endarterectomies (CFEs) were performed on 32 symptomatic patients with iliofemoral occlusive disease (IFOD). These cases were performed as a hybrid procedure where concurrent endovascular treatment for their iliac disease was performed at the same session with common femoral artery endarterectomy. Results: Data was obtained for 32 patients (32 limbs) who underwent hybrid procedures during the study period. Technical success was achieved in 100% (32 patients). Clinical success, according to the American Heart Association (AHA) classification at 1 month showed, 12.5% (4 patients) had grade 3 improvement, 56.3% (18 patients) had grade 2 improvement, and 25% (8 patients) had grade 1 improvement, while 6.3% (2 patients) worsened. During the follow-up period which was 12 months, there were 6 major adverse cardiovascular events (MACE). All our surviving patients except for five patients remained free of symptoms, without need for any other interventions at the time of the last follow-up. Our primary patency rate of the target treatment segment (common femoral and iliac axis) was 93.75% at 12 months. Our secondary patency rate of the target treatment segment was 100% at 12 months, while the freedom from reintervention rate to the treated limb was 84.15% at 12 months. Conclusion: Hybrid approach combining common femoral artery endarterectomy and iliac angioplasty for iliofemoral occlusive disease (IFOD) seems an attractive option for those patients, who are unfit for extensive bypass surgery, especially those with extensive multilevel disease where hybrid procedures can be performed safely, and with good durability. Keywords: Hybrid; iliofemoral; endarterectomy; stenting.