: Open surgery and endovascular therapy are two commonly accepted methods of treatment in patients with extensive aortoiliac occlusive disease (AIOD) with different advantages and disadvantages. The purpose of this study was to compare the rate of vascular graft patency in open surgery with endovascular stent repair in patients with iliac artery occlusion. This was a cohort study. The study population was composed of patients with iliac artery occlusion who underwent open surgery or endovascular intervention for the iliac artery, who were followed up with evaluating the signs and symptoms of remission as well as stent or graft openness. Data analysis was performed on the ultrasound and CT scan using IBM SPSS Statistics 21. A total of 17 patients underwent open surgery and 20 patients under iliac angioplasty. On examination and ultrasound in Group I, 15 patients (88.2%) had an appropriate femoral pulse and Doppler ultrasound showed blood flow within the graft, and in Group II, 18 patients (90.0%) had an appropriate femoral pulse and Doppler ultrasound showed blood flow within stent. There was no significant difference patency between the two groups in graft or stent with a 29-month follow-up (p=1.00). Based on the results from the examination of the role of factors such as diabetes, hypertension, smoking, and drug use, these factors had no significant statistical effect on the intervention outcomes. Patients with acute aortoiliac obstruction (TASC C, D) who underwent open surgery and EVT, had similar results in terms of vascular openness at an approximately 2.5-year follow-up, and these results were independent of diabetes, hypertension, smoking, and drugs.