Objective To observe the technical success rate and short-term clinical outcomes of percutaneous transluminal angioplasty (PTA) in treatment of critical lower limb ischemia in stroke patients with limb dysfunction. Methods Clinical data of 280 consecutive stroke patients with Fontaine Ⅲ?Ⅳ stages and limb dysfunction (326 limbs) admitted in our hospital from January 2008 to December 2014 were collected and retrospectively analyzed. All these patients were treated with PTA. Technical success rate, incidences of complications, clinical efficacy, ankle-brachial index (ABI), and vascular restenosis were observed and evaluated. Results There were 342 PTA performed in 280 patients (326 limbs), and technical success rate achieved 94.8% (309/326). No serious complications occurred. Clinical symptoms were obviously improved after successful PTA. The ABI was significantly increased from 0.26±0.24 before operation to 0.72±0.29 postoperatively, with significant difference (P＜0.05). For the 210 patients (242 limbs) who were followed up for average 27 months (ranging from 3 to 90 months), the ABI was 0.65±0.26 and 0.54±0.31 respectively in 6 and 12 months after treatment, significantly improved than before treatment. Duplex ultrasound imaging showed that the cumulative restenosis ratio was 35.9% in 1 year after operation, and 70 patients of them (28.9%) received reintervention due to recurrence of symptoms. Conclusion PTA is a good approach for lower limb peripheral arterial disease, with higher technical success rate, lower incidence of complications, and exact curative effect, and is the first choice for the disease. Because of the limited functional exercise in the stroke patients with limb dysfunction, they had a higher incidence of restenosis. Further research is needed to improve the surgery success rate and postoperative vascular patency for the occlusive lesions.