Objective To investigate the characteristics and prognosis of arteriosclerosis obliterans in the elderly women. Methods A retrospective analysis was performed of 106 elderly patients (54 males and 52 females) from March 2015 to March 2016 with arteriosclerosis obliterans. The 54 male patients were 60-89 (68.3±13.4) years old, and 52 female patients 59-90 (77.3±7.7) years old. All the patients received endovascular treatment of lower extremity arteries. The two gender groups were compared in terms of the general data and postoperative follow-up, and the female patients were analyzed for the prevalence factors and efficacy of endovascular treatment. SPSS statistics 22.0 was used for data analysis, and Chi-square test for comparison of enumeration data. Results All patients underwent endoluminal surgery and were followed up, with a success rate of 99.1% (failed recanalization in 1 male patient with multi-segment lesions) and a follow-up rate of 94.3%. The female group were significantly advanced in age (P<0.05), with fewer smokers (P<0.05), more complicated with hypertension (P<0.05), greater proportion with distant femoral lesions (P<0.05) and more severe lesions (P<0.05). Perioperative complications occurred in 4 serious patients (3.85%), 2 of whom were female and had myocardial infarction. During the follow-up, in-stent restenosis occurred in 17 patients (13 males and 4 females) and, 3 (2 males and 1 female) died, 5 (3 males and 2 females) amputated. Cardiovascular and cerebrovascular events were reported in 11 patients (2 males and 9 females). Conclusion Compared with the males, the elderly females have a higher average age of onset of lower extremity arteriosclerosis, a higher proportion of concomitant hypertension, a significant smaller number of smokers, and more severe lesions. The elderly females show a lower rate of re-embolism after endovascular treatment than the males, but the incidence of concurrent cardiovascular and cerebrovascular events is significantly higher.