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Introduction: Venous-thromboembolism is common vascular disease affecting lower limbs composed of DVT (2/3 of VTE) and PE (1/3 of VTE). The goal of management of DVT is to prevent PE, recurrence or PTS .Anticoagulation was the cornerstone of DVT management to prevent PE or recurrent DVT. Aim: To review our experience and assess efficacy of EKOS® thrombolysis in management of ilio-femoral DVT at Cumberland infirmary focusing on clinical outcome and any post procedure complications. Results: 22 patients had thrombolysis for illiofemoral DVT over 7years in Cumberland infirmary (Females 16 Males 5). Median age 20-89 years. Total number of treatment Sessions; 1 session: 18.18% (n=4), 2 Session: 54.54% (n=12), 3 sessions: 22.73% (n=5), 4 sessions: 04.55% (n=1). Success rate more than 80%: 90.91.7 % (n=20). Further procedures needed, Stents placement %77.27 (n=17), angioplasty 36.36% (n=8). Outcome; Improvement of symptoms in 90.91% % (n=20) leg ulcer healed in 9.52% (n=2). Post procedure complications: Leg swelling 28.6% (n=6) all are short terms resolved within six weeks and just one long standing leg swelling. Post procedure leg pain is in 19.04% (n=4). Ongoing issues were in 9.52% (n=2) and were persistent leg ulcer and PTS in each. One patient had recurrence. No patient had PE/ intracranial bleeding. Conclusion: EKOS is effective in treating acute ilio-femoral DVT with patency at 80% and more at the cessation of treatment, as well as prevention of DVT related long term complication (recurrence-PE and PTS) in comparison of conventional CDT or anticoagulation alone.