The conventional balloon angioplasty of infrainguinal arteries requires the use of fluoroscopy and injection of contrast material. We attempted to perform 360 balloon angioplasties of the superficial femoral (SFA) and/or popliteal arteries under duplex guidance in 274 patients to avoid the nephrotoxic effect of contrast and eliminate or minimize radiation exposure. Critical ischemia was the indication in 35% of cases and severe claudication in 65%. Infrapopliteal angioplasties of 80 arteries were attempted in 54 cases (15% of all cases) in order to improve the run-off after completion of femoral-popliteal angioplasties. For femoral-popliteal segment, overall technical success was 95% (342/360 cases). For infrapopliteal arteries, technical success was achieved in 77 of 80 cases, with an overall success rate of 96%. Twelve-month patency rates for TASC class A, B, C, and D lesions were 90%, 59%, 52%, and 46%, respectively. PAVF <100 mL/min was the most powerful predictor of 30-day and 6-month arterial thrombosis following femoral/popliteal balloon angioplasties.