Endovascular therapy is useful in the treatment of symptomatic peripheral arterial disease (PAD). Recent device advances have resulted in favorable long-term results in iliac arteries as well as minor arteries such as the femoral and popliteal arteries. When standard treatments fail to enhance quality of life and function, endovascular procedures are explored. Critical limb ischemia and acute limb ischemia, on the other hand, endanger the limb and necessitate more immediate revascularization. Endovascular therapies for aortoiliac disease have a longer long-term durability than femoral popliteal disease. In general, infrapopliteal revascularization is reserved for critical and acute limb ischemia. Endovascular treatment relies heavily on balloon angioplasty and stenting. Drug-eluting stents and drug-coated balloons are two new, well-tested inventions. Adjunctive devices for crossing chronic complete occlusions or debulking plaque with atherectomy have received less serious research and have limited roles. Patients undergoing endovascular operations require a planned follow-up care strategy. This involves aggressive treatment of cardiovascular risk factors in order to avoid myocardial infarction and stroke, the two leading causes of mortality. Limb surveillance seeks to detect restenosis and new disease outside the intervening segments, both of which might jeopardize patency and result in recurring symptoms, functional impairment, or a threatened limb. This article discusses the history and recent breakthroughs in endovascular treatment of peripheral vascular disorders, as well as device features and applications. Endovascular therapy of peripheral vascular disease has progressed in lockstep with the introduction of devices such as catheters and stents. As a result, endovascular therapy is currently recommended as the first-line treatment for PAD in recommendations.