Current percutaneous treatment strategies for acute limb ischemia (ALI) include catheterdirected thrombolysis (CDT) and mechanical thrombectomy. However, about 20% of these patients can have contraindications to thrombolytic therapy. Mechanical thrombectomy is the only option in such patients except for surgical candidates. Manual aspiration thrombectomy using a large-bore aspiration catheter is a preferred first option. However, this technique is sometimes insufficient when the thrombi burden is significant with the risk of distal embolization. In this case report, we would like to introduce a case with acute limb ischemia successfully treated with stentassisted thrombectomy when contraindicated for thrombolysis and failed simple aspiration thrombectomy alone.