Background: With recent advances in equipment and technique, infrapopliteal angioplasty has shown comparable results to surgical bypass in patients with critical limb ischemia (CLI). In this study, we evaluated the efficacy and the feasibility of infrapopliteal angioplasty in Korean patients with CLI. Methods: Between March 2002 and May 2008, infrapopliteal angioplasty was performed on 118 limbs of 101 patients (79 male; mean age 66 yrs) with CLI (Rutherford category 4, 5 or 6). Freedom from reintervention, limb salvage, and overall survival were analyzed. Results: The median follow-up duration was 30 months. Initial technical and clinical success rates were 69.5% and 83.1%, respectively. No major complication requiring surgical intervention developed after angioplasty. Among 82 limbs with initial technical success, the rate of freedom from any reintervention at 2 years was 70.7% and that from limb salvage was 97.6%. Gangrenous change at initial presentation was an independent predictor associated with poor 2 year primary patency in these patients with CLI. Overall survival at 1 year was 86.4% and that at 2 years 76.3%. The absence of claudication at initial presentation and history of cerebrovascular accident were independent predictors associated with poor 2 year survival in theses patients. Conclusion: Infrapopliteal angioplasty showed favorable clinical outcome and feasibility as a primary choice of treatment in Korean CLI patients.