Background: Endovascular treatment (EVT) is considered as an effective treatment in patients (pts) with significant lower extremity peripheral arterial disease (PAD). There are very limited data whether the hs CRP is associated with procedural and clinical outcomes following lower extremity percutaneous translumianl angioplasty (PTA). Methods: This study consisted of 81 consecutive lower extremity PAD pts who were treated with PTA enrolled from June 2004 to November 2008. Among these pts, 50 pts (61.7%) had high hs CRP (>2mg/L) with significant PAD. Procedural success, complications and clinical outcomes of high hs CRP group (n=50 pts) were compared with those of normal hs CRP group (n=31 pts) up to 6 months. Results: The baseline characteristics including ischemic symptoms according to Rutherford Chronic Limb Ischemia Classification were similar between two groups except higher incidence of smoking in the normal hs CRP group (56.3 vs. 83.9%, P=0.01, Table). The incidence of periprocedural complications including thrombus and the cumulative incidence of repeat PTA (target lesion revascularization,TLR and target vessel revascularization, TVR) up to 6 months were higher in the hs CRP group (Table). Multivariate logistic analysis showed that high hs CRP was an independent risk factor for repeat PTA TLR (odd ratio; 8.44, 95% confidence interval; 1.89-37.58, p=0.005). However, the incidence of death was not different between the two groups. Conclusions: In our study, high hs CRP level was an independent predictor for adverse clinical outcomes including post procedural thrombus and repeat PTA in PAD pts. High hs CRP may associated with higher incidence of thrombosis and repeat revascularization following PTA