Introduction: Behcet's disease (BD) was first described by the Turkish dermatologist (HulusiBehcet). The aim of this study to revise our arterial endovascular repair in those patients. Methods: A retrospective analysis was carried out for prospectively collected data of all cases presented with peripheral arterial aneurysms associated with BD and received surgical intervention between January, 2012 and January, 2016. All patient suspected to have BD due to recurrent orogenital or ocular ulceration were referred to Dermatology department to independently confirm or rule out the diagnosis of BD. An endovascular first approach was always sought. Open surgical repair (OSR) was only performed in case of failure or non-feasibility of endovascular repair (EVR). In case of use of stent-grafts, a minimal oversizing of less than 10% was planned to avoid arterial rupture or induction of pseudoaneurysms at landing sites. In case of OSR, wrapping with PTFE graft was carried out over the repair site to decrease the incidence of anastomotic pseudo-aneurysms. Results: Between January 2012 and January 2016, 14 cases, with 15 peripheral arterial aneurysms were identified. Age ranged from 23 to 48 (Mean 32.2) years. 10 cases (11 aneurysms, 73%) were managed electively, presenting with pulsatile mass, while the other 4 (27%)presented to emergency department with ruptures (P=0.023). Two of the ruptures were associated with limb ischemia, and 3 of the elective cases were associated with deep venous thrombosis (DVT).Aneurysm distribution included 8 in superficial femoral artery(SFA), 5 in common femoral artery (CFA) including a case of bilateral CFA aneurysms, and 2 in the external iliac artery (EIA).Endovascular approach was attempted in 13 aneurysms (12 cases, 87%), with 1ry technical success in 9 (69%), and assisted 1ry success in 1 case (8%), and failed in 3 (23%). P= 0.087. Open repair was the first approach in 2 cases (13%), presenting with rupture. One case presented after 5 weeks with early recurrence and reperfusion of the aneurysm due to stent migration (inadequate overlap of 2 stent grafts), and was managed successfully with a bridging stent graft. Conclusion: Endovascular approach as a first option for treatment of peripheral arterial aneurysms with Behcet's Disease, is a feasible and safe strategy that can allow for less invasive interventions for such challenging cases. It provides an effective treatment solution that can accommodate most of the cases presenting electively or in emergency situations. The incidence of recurrence and complications can be greatly reduced by adopting a strict strategy of controlling the activity of the disease medically prior to intervention, whenever possible, and maintaining remission after the surgical treatment. Disclosure: Nothing to disclose