Author's summary Endovascular therapy is considered as an alternative to surgical bypass as the first-line treatment in patients with chronic limb threatening ischemia. However, the risk factors for poor long-term outcomes are not extensively studied. We investigated long-term clinical outcomes in chronic limb threatening ischemia patients who underwent endovascular therapy and found that end-stage renal disease, Rutherford category-6, and suboptimal endovascular therapy were common predictors for poor outcomes. These findings are emphasizing the importance of renal function and wound severity in the prognosis of chronic limb threatening ischemia and suggest the importance of more complete revascularization.