Symptomatic atherosclerosis of the lower extremity arteries is becoming more prevalent each year. Atherosclerotic stenosis or occlusions of femoral and popliteal arteries may often co-exist with aorto-iliac or distal lesions. Treatment options depend on severity of disease, localization of atherosclerotic plaques and comorbidities. The main objective of treating patients with atherosclerotic peripheral artery disease affecting lower extremities is limb salvage and relief of symptoms. Endovascular interventions are able to improve limb salve rates and prognosis of disease, as well as to avoid open and often traumatic reconstructive surgical procedures on the lower extremities. However, postoperative restenosis is still one of the key problems following percutaneous angioplasty and/or stenting. Endothelial mesenchymal transition is regarded as a possible key pathogenetic mechanism underlying restenosis. This article is dedicated to EndMT and its possible role in restenosis.