Background <p>Deep vein thrombosis (DVT) is a serious condition that can lead to complications such as pulmonary embolism (PE) and post-thrombotic syndrome (PTS). This study aimed to compare the Straub-Rotarex thrombectomy system and catheter-directed thrombolytic therapy (CDT) for lower limb DVT.</p> Methods <p>This retrospective study analyzed patients with DVT treated at The Second Hospital of Shanxi Medical University between August 2017 and October 2021. The patients were grouped according to the CDT group or the Straub-Rotarex thrombectomy system (Straub-Rotarex group).</p> Results <p>This study included 100 patients, with 50 in the Straub-Rotarex group (27 males, mean age of 61.61 ± 3.35&#xa0;years) and 50 in the CDT group (28 males, mean age 61.12 ± 3.12&#xa0;years). The Straub-Rotarex thrombectomy group achieved a higher total effective rate (96.00%) than the CDT group (84.00%) and a lower re-thrombosis rate (4.00% vs. 18.00%). Post-treatment, the Straub-Rotarex group exhibited significantly lower activated partial thromboplastin time (APTT), D-dimer (D-D), prothrombin time (PT), fibrinogen (Fbg), and thromboplastin time (TT) levels (P &lt; 0.05), a lower Porter score (P &lt; 0.001), and smaller differences in calf and thigh circumference (P &lt; 0.001).</p> Conclusion <p>The results suggest that the Straub-Rotarex thrombectomy system may help achieve a high effective rate and fewer complications than CDT. The results must be confirmed in a clinical trial.</p>