Laser thermal angioplasty is a new technique. The longest follow-up is 3 years. It is used increasingly for the treatment of atheromatous disease of the femoropopliteal segment. The authors describe a case of successful recanalization of a completely occluded left external iliac artery using laser thermal angioplasty. The artery was approached through a left femoral dissection. The patient was discharged from the hospital on postoperative day 4 without claudication. The present indications and potential benefits and complications of this procedure are discussed.