Background: Chronic dialysis patients (pts) are at an increased risk of peripheral artery disease. Outcome of below the knee (BTK) intervention in dialysis patients remains poorly understood. The aim of this study is to clarify the BTK intervention outcomes in dialysis pts as compared with those without on dialysis. Methods: A total 82 consecutive patients who underwent BTK intervention were enrolled for the study. Study population was divided into 2 groups; Control group-no dialysis (n= 68 pts, 105 lesions) and Dialysis group-peritoneal or hemodialysis (n=14 pts, 34 lesions). Procedural and major clinical outcomes up to 1 year were compared between the two groups. Results: Baseline clinical, procedural and angiographic characteristics were similar between the two groups. Post procedural ischemic complications and major clinical outcomes including mortality and repeat PTA were similar between the two groups up to 1 year. However, the incidence of surgical intervention for wound management including ostectomy & amputation were significant higher in the dialysis group. (Table) Conclusions: In this study, despite of similar major angiographic and clinical outcomes following successful BTK intervention in dialysis pts, they had significant higher rate of surgical intervention including ostectomy and amputation up to one year, suggesting special care with intensive medical management should be recommend.