Objective To compare the efficacy of revascularization of profound femoral artery versus superficial femoral artery on TASC type D arteriosclerosis obliterans. Methods Clinical data of 45 cases of TASC type D arteriosclerosis obliterans admitted in our hospital from January 2007 to December 2010 were collected and retrospectively analyzed. Sixteen patients received endovascular balloon dilation combined with stent implantation into superficial femoral artery, and another 16 patients underwent similar revascularization but into profound femoral artery. The efficacy variables including ankle-brachial index (ABI), amputation rate in 3 years after surgery, and the relief of symptoms were used to evaluate the efficacy of the 2 approaches in the 32 cases. Results Revascularization resulted in significant increases in ABI in the 2 groups (P＜0.05), with the post-operative value of the superficial femoral artery group obviously higher than that of the other group (P＜0.05). There were no significant differences in the numbers of patients having claudication in less than 200 m and undergoing amputation in 3 years after surgery (P＞0.05). Conclusion For the patients with TASC type D arteriosclerosis obliterans but iliac artery patency, revascularization of either superficial or profound femoral arteries is an effective treatment to relieve symptoms and enhance blood flow of the ischemic limb. Stent implantation into the superficial femoral artery is more superior in short-term blood supply for distal limb.