54-year-old male with multiple comorbidities presented to the clinic for evaluation of severe left calf pain (Rutherford Category 4). ABI was 0.68 on the left. US arterial duplex revealed 1.7cm popliteal artery aneurysm associated with complete occlusion. Angiogram with IVUS showed a thrombotic occlusion of a left popliteal artery aneurysm. Patient deemed high risk for surgical approach. Percutaneous intervention was adopted s/p PTA and IVUS guided covered stent deployment. Patient had unlimited exercise tolerance at 1-month follow-up. Repeat arterial duplex showed patent endovascular stent with no endoleak.