Objective To evaluate the clinical efficacy and safety of TurboHawk plaque system in lower extremity atherosclerotic occlusive disease. Methods A retrospective analysis was made of the clinical data of 23 patients with lower extremity atherosclerotic occlusive disease admitted to the Vascular Surgery Department of Yibin First People′s Hospital from March 2017 to June 2018. The TurboHawk plaque system was selected for intervention. An ankle brachial index (ABI) was performed for all the selected patients before and at 3 days after procedure. The patients were followed up for 6 months. The clinical data and follow-up findings before and after surgery were compared. SPSS statistics 19.0 was used for data analysis. The t test was used for comparison between groups. Results ABI at 3 days postoperatively was significantly higher than preoperative reading [(0.81±0.13) vs (0.26±0.19), t=31.52, P=0.012]. The treatment were markedly effective in 9 patients and effective in 14. Postoperative retroperitoneal hematoma occurred in 1 patient, plaque radial artery embolization in 1, anterior tibial artery rupture in 1, and superficial femoral artery dissection was performed in 1 patient, complication rate being 17.4%(4/23) and all being improved after treatment. After 6 months of follow-up, all patients showed no obvious resting pain, and only 1 patient developed claudication. All of the 6 patients with lower extremity ulcers were healed within 4 months after surgery without recurrent ulcers during follow-up. There was no significant difference in ABI at 6 months after surgery compared to 3 days after surgery [(0.81±0.17) vs (0.81±0.13), P>0.05]. Conclusion TurboHawk plaque system is an effective option worthy of popularization for patients with lower extremity atherosclerotic occlusive disease, with minimal invasiveness and satisfactory efficacy and safety.