The chronic obstruction of the aortic bifurcation and iliac axis was definide by the French surgeon Rene Leriche, whose name it bears today. The advancing age of the population move the definition from a syndrome, as reported from Leriche, to complex aortoiliac vascular lesions current multidisciplinary guidelines recommend to treat extensive aortoiliac occlusive disease by surgical revascularization. Surgery provides good long-term patency, but at the cost of substantial perioperative morbidity. Development of new technologies and techniques has led to increased use of endovascular therapy for extensive aortoiliac disease. This review article summarized current multidisciplinary guidelines indication in endovascular treatment of extensive aorto-iliac disease and the various worldwide single centre experience published on endovascular treatment of Leriche Syndrome.