Objective To investigate the efficacy of endovascular treatment with angioplasty for infrapopliteal arterial occlusive disease (including thromboangiitis obliterans, arteriosclerosis obliterans, and diabetic foot). Methods Clinical data of 40 cases (40 limbs) of infrapopliteal arterial occlusive disease hospitalized in our hospital from March 2008 to July 2014 were collected and retrospectively analyzed. They all were treated by percutaneous transluminal angioplasty (PTA) for balloon dilatation of the stenotic or occlusive vessels. Results Angiographic success was achieved in 39 limbs (postoperative rate of stenosis＜20%), and the clinical success and initial opening rate was 97.5% (39/40). Limb preservation rate was 95%(38/40), and the limb salvage rate was 97.5%(39/40). The complications in the cohort was arterial perforation (2 cases), hematoma in the puncture site (1 case), and acute myocardial infarction (1 case). After the operation, symptoms such as pain, ulcers and intermittent claudication were improved in the 39 patients. The ankle-brachial index (ABI) was increased from 0.32±0.27 before the operation to 0.86±0.19 at day 10 after the treatment, with statistically significant difference (P＜0.01). The ABI was 0.80±0.20 and limb preservation rate was 95% (38/40) in 12 months after the operation. Conclusion PTA is a safe and effective approach for infrapopliteal arterial occlusive disease.