Obstructive lesions of the abdominal aorta that progress to the level of the renal artery are called proximal renal artery abdominal aortic occlusions and are a less common disease in vascular surgery. About 8-10% of lower extremity arterial occlusions involve the abdominal aorta, of which 50% of abdominal aortic occlusions extend retrogradely to the level of the renal artery, and some complete obstruction of the abdominal aorta occurs in renal artery occlusions. The recognition and treatment of this disease is a gradual process. 1923 Leriche first reported a case of arterial occlusion of the bifurcation of the abdominal aorta and proposed the concept of using a graft to reconstruct the lower extremity arteries from the abdominal aorta. 1947 Santos first proposed that endarterectomy could be used in peripheral atherosclerotic occlusive disease, followed by Wylie’s application of endarterectomy to treat main iliac artery occlusions. In 1952, Voorhees used Vylon grafts for revascularization. In 1971, Wang Zhonghao pioneered the use of a homemade balloon catheter for the treatment of arterial embolic lesions, which avoided the need for an open abdomen when treating trans-abdominal aortic emboli and reduced the perioperative mortality rate from 46% to 10%. The treatment of proximal renal artery abdominal aortic occlusion varies, and the surgical approach and complications are not identical to those of main iliac artery occlusion, especially in patients with compromised renal function. The current treatment of proximal renal artery abdominal aortic obstruction is a combination of general conventional therapy to eliminate risk factors, pharmacological therapy, and surgical treatment. The progression of the disease is often progressive, and the degree of establishment of collateral circulation after stenosis or occlusion of the proximal renal aorta directly affects blood perfusion to the distal limb. Clinical manifestations depend on the rate and degree of progression of ischemia and the compensation of the collateral circulation. It may manifest as symptoms of hip and lower extremity ischemia with limb movement disorders, intermittent claudication, resting pain, and gangrene. Some patients have mild or even asymptomatic clinical symptoms.