The initial and long-term results of percutaneous transluminal angioplasty (PTA) were assessed in 254 atherosclerotic lesions of the ilio-femoro-popliteal arteries in 130 patients. There were 122 men and 8 women, aged 36-85 years (average, 68 years). Follow-up periods ranged from 1 to 131 months, with a mean of 42 months. PTA was performed in 6 patients in Fontaine's stage I, 112 patients in stage II, and 12 patients in stage III-IV. We reported initial success rates of 92%, 58%, 83% and 74% for iliac stenosis, occlusion, femoro-popliteal stenosis and occlusion, respectively. Overall, the initial success rate was 82% (203/247). The 5-year patency rates according to Kaplan-Meier analysis were 70%, 69% and 63% for iliac stenosis, occlusion and femoro-popliteal stenosis, respectively. In femoro-popliteal occlusion, the 1-year patency rate was 42%, which was significantly worse than that for stenosis (P < 0.01). The longest patency periods obtained were 131 months in the iliac artery, and 106 months in the femoro-popliteal artery. The recurrence rate within 6 months was significantly higher in patients with diabetes. The recurrence rate between 6 and 12 months was significantly higher in patients with poor run-off, and those of advanced age.