Endovenous stenting of the iliocaval venous system (EndoVS) has become a viable and efficacious option for treatment of venous occlusive disease of the lower extremity. We reviewed our initial experience with this procedure to assess patient outcomes. We undertook a retrospective chart review of all EndoVS performed by vascular surgeons at the Vancouver General Hospital between February 2013 and December 2015. Patient demographics, procedure details, complications, and follow-up data were collected from the patients' charts. Data are presented descriptively. EndoVS was performed in 18 patients from February 2013 to December 2015. Fifteen of the patients (83.3%) had a prior history of deep venous thrombosis. Three of these patients (16.7%) had recent deep venous thrombosis treated with catheter-directed thrombolysis. Eight patients (44.4%) had preoperative imaging evidence of May-Thurner syndrome. Preoperative clinical, etiologic, anatomic, and pathophysiologic (CEAP) classification was C3, C4, C5, or C6 in six, five, two, and five patients, respectively. Thirteen patients (72.2%) had symptoms of venous claudication. All patients received magnetic resonance venography before intervention. All procedures were performed percutaneously in the operating room with mobile fluoroscopy, duplex ultrasound, and intravascular ultrasound guidance. Four patients had complete occlusion of the inferior vena cava requiring recanalization and inferior vena cava stenting. Technical success was 100%. One case was complicated intraoperatively by proximal stent migration requiring piecemeal endovenous retrieval. All patients were discharged on anticoagulation. Median clinical follow-up was 5.8 months (interquartile range, 5.0-10.0). At this time, 13 patients (72.2%) had significant improvement in their symptoms of swelling or venous claudication, whereas 2 patients had minimal change. Two patients had initial improvement followed by return of their symptoms, one of whom underwent a second procedure and is doing well postoperatively. One patient stopped anticoagulation early against medical advice and presented with thrombosis of the venous stent requiring thrombolysis and venoplasty. All five patients with CEAP C6 disease demonstrated healing of their chronic venous ulcers. Median imaging follow-up was 7.4 months (5.4-10.4). Primary patency was 88.9%. Secondary patency was 94.4%. Our initial experience with EndoVS is favorable with clinical improvement in the majority of patients. Primary patency and secondary patency in this short-term follow-up were excellent. Long-term follow-up is required to properly assess the durability of these procedures.