In-stent restenosis (ISR) occurs in half of the patients treated with stenting of femoral and popliteal artery for lower extremity arteriosclerotic occlusive disease despite revolutionized treatment of lower extremity arteriosclerosis obliterans (LEASO) as a result of the continuous renewal of Ni-Ti alloy stent. ISR, occurring commonly at long and complicated lesions with complex causes and mechanisms, is treated non-surgically and with vascular recanalization. Non-surgical treatment includes quitting smoking, control of blood sugar, blood lipids and blood pressure, anticoagulation, and active exercise, and medication. Vascular recanalization consists of conventional open surgery, Forgart catheter thrombectomy, intraductal contact thrombolysis, percutaneous transluminal angioplasty (PTA), percutaneous transluminal angioplasty and stenting (PTAS), and percutaneous plaque resection, excimer laser atherectomy (ELA), and endovascular brachytherapy (EVBT). Combined therapy is mainly used clinically to obtain better medium- and long-term treatment outcomes and reduce the occurrences of reintervention. In this article, we reviewed the causes of ISR and research progress in vascular recanalization treatment.