Background: The preference of endovascular technique to treat arterial occlusive disease has increased in recent years. Superficial femoral artery (SFA) stenting is associated with a high risk of in-stent restenosis (ISR); however, the data on the outcomes of repeat endovascular treatment of SFA-ISR are limited. Thus, the purpose of this study was to review the mid- and long-term outcome and durability of repeat endovascular treatment of SFA-ISR. Methods: A single institution retrospective chart review study was performed for patients who were diagnosed with SFA-ISR by angiographic method from March 2002 to March 2011. Clinical and procedural characteristics, angiographic findings, and 6-month, 12-month and 24- months primary patency rates were analyzed. Results: SFA-ISR was diagnosed across 55 limbs of 52 patients, to which endovascular treatment was attempted. The patients��� symptoms were classfied as stated by Fontaine classification into class IIa, IIb, III, and IV: there were 4 (7.3%), 22 (40%), 23 (41.8%), and 6 (10.9%) cases, respectively. The median duration from the insertion of stent into SFA to occurrence of ISR was 314 days (range: 69~2436 days), and ISR type II, III, and IV was found in3 (5.5%), 10 (18.2%) and 42 (76.4%) limbs, respectively. Technical success was achieved in 51 limbs (92.7%). Balloon angioplasty, additional stent implantation, and excisional atherectomy were the primary therapy in 35 (68.6%), 9 (17.6%) and 7 (13.8%) of the cases, respectively. Adjunctive balloon angioplasty was performed after additional stent implantation and excisional atherectomy in all cases, and intra-arterial urokinase were used in 9 cases (15.3%) for large thrombotic burden. Primary patency rates on 6, 12 and 24 months were 79.3, 69.6 and 55.0%, respectively. Procedure-related complications which needed additional operation or intervention were found in 2 cases (3.6%); one case needed emergency operation for perforation, and another case involved embolization of a pseudoaneurysm. Conclusion: Endovascular treatment of SFA-ISR showed high technical success rate and low rate of complication, as well as feasible mid- and long-term outcome. Therefore, it could be considered as viable treatment option prior to choosing a surgical strategy.