Objective To investigate the clinical effect of AngioJet thrombus aspiration combined with endarterectomy in the treatment of acute lower extremity arterial ischemia. Methods Clinical data about 60 acute lower extremity arterial ischemia patients admitted to the Beihai People’s Hospital from June 2018 to December 2021 were retrospectively analyzed.According to different treatment plans, they were divided into the basic group (30 cases, Fogarty catheter thrombectomy combined with endomycotomy) and the experimental group (30 cases, AngioJet thrombus aspiration combined with endomycotomy). Perioperative indexes, coagulation function, thrombus clearance, lower limb artery patency, lower limb vascular lesions and complications were compared between the two groups. Results The operation duration of the experimental group was longer than that in the basic group, and the hospitalization time was shorter than that in the basic group ( P <0.05).After surgery, serum fibrinogen(FIB) and D-dimer (D-D) levels in two groups were lower than those before surgery, and prothrombin time (PT) was longer than those before surgery, and serum FIB and D-D levels in experimental group were lower than that in basic group, and PT was longer than that in basic group( P <0.05).The surgical success rate, thrombus clearance rate and lower limb artery patency rate of the experimental group were higher than those of the basic group ( P <0.05). After surgery, the peak velocity of dorsal pedis artery, dorsal foot artery blood flow and ankle brachial index (ABI) in two groups were higher than those before surgery,and the experimental group was higher than that in the basic group ( P <0.05). The complication rate of the experimental group was lower than that of the basic group ( P <0.05). Conclusion AngioJet thrombus aspiration combined with endarterectomy is safe and effective in the treatment of acute lower extremity arterial ischemia, which can effectively remove thrombus, restore lower limb blood flow, relieve clinical symptoms and has a high patency rate.