Atherosclerotic occlusive disease of the aortic crossroads and iliac axes is the preferred site for atherosclerotic disease, which is a general disease that can affect all medium- and large-caliber arteries.The management of these patients has benefited from advances in diagnostic imaging based on ultra-sonographic, CT and angiographic explorations. The therapeutic options for aorto-iliac occlusive disease are endovascular and surgical treatment, both of which have undergone considerable expansion, aided by increasingly high-performance imaging tools. Endovascular treatment is indicated mainly for focal lesions of moderate length, whereas surgery is indicated for patients with long, multiple lesions. Surgery is associated with a significant morbidity and mortality rate, dominated by cardiac and digestive complications.