Background: Peripheral arterial disease (PAD) is a progressive atherosclerotic condition characterized by narrowing or blockage of arteries that supply the limbs, leading to ischemia and functional impairment. These vessels are crucial for maintaining distal blood flow, and their obstruction can lead to critical limb ischemia (CLI), increasing the risk of ulceration, gangrene, and limb loss.1 Objective: To assess the outcomes of balloon angioplasty in patients with occlusive diseases of small and medium sized arteries of limbs Material and method: it’s a prospective observational study of 35 patients of PAD ,who were referred to interventional radiology for angioplasty. Angioplasty/ stenting was done under DSA guidance after preoperative evaluation by CT angiography. Result: Complete resolution was observed in short-segment occlusions at 3 months, with only minor recurrence (2.9%) at 6 months. Long-segment occlusions also showed a significant reduction, with single-segment cases decreasing from 71.4% preoperatively to 20.0% at 6 months. PSV increased significantly across all infrapopliteal arteries, particularly in the Dorsalis Pedis artery (p<0.001), indicating improved perfusion. Conclusion: This study highlights the efficacy of balloon angioplasty in managing occlusions in small and medium-sized arteries of the limbs, demonstrating significant improvements in arterial patency and clinical outcomes.