Objective To investigate the clinical effect of intracavitary interventional therapy in iliac artery occlusion in the elderly.Methods A retrospective analysis was made of 21 elderly patients with iliac artery occlusion in the Department of Vascular Surgery of Weifang People′s Hospital from October 2010 to October 2016. All the patients were diagnosed by computed tomography angiography via the arteries in the lower extremity before operation and were graded according to the Trans-Atlantic Inter-Society Consensus. Changes of ankle-brachial index (ABI) were recorded preoperatively and postoperatively at 3,6, 12 and 24 months, and changes of patency rate of iliac artery were calculated. SPSS statistics 19.0 was used for data analysis. The measurement data were analyzed with t-test, and Kaplan-Meier survival curve analysis was performed for patency rate. Results Different treatment choice should be made for iliac artery occlusion of different lesions. Thrombolytic catheter can be retained for thrombolytic occlusion. In the case of iliac artery occlusion caused by arteriosclerosis, balloon dilatation of and stent implantation in the iliac artery were performed in the first stage. No perioperative death occurred. ABI was 0.92±0.20 at 3 months, 0.90±0.18 at 6 months, 0.84±0.14 at 12 months and 0.79±0.21 at 24 months after operation, being significantly improved as compared with that before operation (P<0.01). The patency rate was 95.7% at 6 months, 80.2% at 12 months, and 72.9% at 24 months. Conclusion Total intracavitary treatment of iliac artery occlusion is minimally invasive, and has good mid-term efficacy, which is particularly suitable for the elderly.