There for conflicting data regarding the benefits of primary stent implantation compared with balloon angioplasty with provisional stent implantation in SFA. Aim: to evaluate the primary patency of long superficial femoral artery lesions treated by nitinol self-expandable stent after 12month follow-up as a primary end point. Secondary end -point was to evaluate clinical and hemodynamic improvement after 12 month follow-up. Methods: The study group included 30 patients with chronic lower limb ischemia. The age of these patients ranged from 53 to 75 with a mean age of 64years. They were performed in the vascular and interventional Radiology Unit., Kasr El Aini Hospital, Cairo University and 6th O'ctober insurance hospital. Interventional procedures were performed in an angiographic interventional room with high resolution C- arm fluoroscopy, road mapping and digital subtraction capabilities. Parameters evaluated including: Rutherford category, walking distance, ankle –brachial index and preconditions for risk factor. Results: Only one patient developed a small groin hematoma which didnot required evacuation and spontaneously resolved under conservative treatment. One patient developed contrast-induced nephropathy which required a single hemodialysis section. Kidney function improved thereafter. The improvement of ABI, walking distance and the Rutherford classification improvement showed high significance (P < .001). Follow-up time was 12 months. No patients died during follow-up.Follow-up ABI values were 0.89 ± 0.28.The improvement of the ABI went parallel to the increase of walking distance and Rutherford classification on a highly significant level (P < .001). After 24 months, primary patency was 86.66%. 4 cases restenosis (13.33 %) were found. Two cases of them occurred within the first six months. Endovascular recanalization was performed as stent in stent procedure, PTA alone for three cases .one femoropopliteal bypass as secondary procedure. Conclusion: Long SFA lesions treated successful by nitionl stenting with primary patency rate 88%, and as a successful procedure for limb salvage. Clinical deterioration occurred in only a small number of patients, and all of them were retreated by endovascular therapy or underwent bypass surgery with supragenicularanastomosis. These observations confirm that the initial endovascular approach for long lesions did not complicate further patient management after clinical stent failure. Furthermore, at the time of follow-up, the patients had a sustained clinical and hemodynamic benefit compared to baseline.