Background Endovascular recanalization has become the preferred method of treatment for many patients with symptomatic femoropopliteal (FP) occlusive disease. Aim To study the efficacy of multiple level arterial angioplasty on limb salvage. Patients and methods This is a prospective, nonrandomized study that included 35 patients with critical lower limb ischemia due to multilevel arterial atherosclerotic occlusive disease treated with endovascular revascularization between August 2015 and July 2016 and followed up for 12 months. Primary outcome parameters included technical success proved by completion angiogram and distal pulse retrieval. Secondary outcome parameters included limb salvage, disappearance of the rest pain, wounds healing, and claudication distance improvement. Results Angiographically, 62.9%had both FPand infrapopliteal segment lesionswhile 37.1% had FP lesions only, and about 50% of our cases were Trans-Atlantic Society Consensus (TASC) II A. Technical success was recorded in 31 (88.6%) patients with failure to cross the lesion occurring in four (11.4%) patients. Cumulative limb salvage rates were 96.7, 90.3, and 80.6 at 3, 6, and 12 months, respectively. Conclusion The endovascular approach is safe and effective in the management of multilevel arterial atherosclerotic occlusive disease with high technical success rate and accepted percent of limb salvage for 1 year.