Intermittent claudication is a symptomatic manifestation of peripheral arterial disease most commonly resulting from atherosclerotic plaque. In addition to intensive medical management to decrease progression of atherosclerotic disease and improve overall cardiovascular health, revascularization either by open or endovascular approach can improve patients’ quality of life by improving pain-free walking distance. This chapter reviews the importance of patient selection for various forms of revascularization, including the available evidence on longer-term outcomes after intervention.