Iliac artery rupture during iliac artery stenting for TASC II C and D lesions was treated with a prolonged low-pressure balloon inflation followed by placement of a covered stent requiring an 8F sheath in the brachial artery. Brachial artery thrombectomy and repair of the brachial artery with a vein patch after removal of the sheath resulted in reestablishment of left arterial flow to the left upper extremity. Common femoral endarterectomy was performed 6 weeks later. The patient has been followed for 30 months with a satisfactory outcome.