Abstract Background Chronic mesenteric ischemia (CMI) can be treated with surgical revascularization (SR) or endovascular revascularization (ER). - The management of symptomatic atherosclerotic chronic mesenteric ischemia which is an uncommon disorder is challenging. Although surgical revascularization (SR) has been considered as the gold standard since its introduction based on observational data published over the last 25 years, there has been increased use of endovascular revascularization (ER) in treating CMI. This review seeks to assess, through the available literature, the role of endovascular intervention in management of chronic mesenteric ischemia and determine the benefits as well as the withdraws of the intervention. Objective to assess the role of endovascular intervention in management of chronic mesenteric ischemia and determine the efficacy (in terms of patency), and safety, (in terms of perioperative morbidity and mortality) of endovascular revascularization (ER) in treating patients with CMI, using the currently available literature and applying a systematic review and meta-analysis. Methods The review is a meta-analysis and systematic review that included randomized controlled trials (RCT), case series and retrospective studies which studied the role on endovascular techniques of management of chronic mesenteric ischemia. Results Abstracts of articles that were published from 2000-2020 identified using the search strategy were reviewed and articles that appear to fulfill the inclusion criteria were retrieved in full text. Data on at least one of the outcome measures was included in the study. This study included published papers and research written in English language that published from 2000-2020. We excluded papers not written in English, studies before 2000 and case report study. Conclusion Endovascular management of chronic mesenteric ischemia is a feasible strategy associated with increased technical and clinical success rate and patency rates. It also associated with low rate of mortality and complications. Restenosis and symptom recurrence were reported in more than 20% of the patients which necessitating preoperative assessment of abdominal pain, good selection of patients and improving the endovascular technique.