Endovascular intervention has gained popularity as the first line option in the treatment of peripheral arterial disease and diabetic foot with technological improvements and increasing experience. A dedicated approach is essential in the treatment of diabetic foot because of its specific footprints in the vascular tree, special difficulties in the endovascular intervention, associated high prevalence of associated comorbidities and higher major amputation rates than nondiabetic population. Although endovascular intervention is accepted as a first-line option in the treatment of diabetic foot, a multidisciplinary approach is essential to organize the treatment steps and to determine the option for revascularization. The local experience of the institute is critical for revascularization. TASC II is universally accepted as the main guide in the treatment of peripheral arterial disease, but not a specific paper for diabetics and it lacks recommendations for below the knee region. There is especially a gray zone for the options of revascularization in below the knee region that is a real target for diabetics. The improvements in the technology and increasing experience of endovascular intervention makes the endovascular revascularization the first line treatment in this patient population.