Endovenous procedures have been shown to offer an effective treatment for Iliofemoral deep venous thrombosis with a clinically relevant reduction in postthrombotic syndrome (PTS) compared to anticoagulation alone. Catheter-based thrombolysis reduces the risk of PTS but has been shown to cause periprocedural bleeding in about 3%. This review finds that mechanical thrombectomy has emerged as an ideal technique, with thrombus extraction without bleeding and a significant reduction in PTS at 12 months. A large randomised controlled trial including this technique versus anticoagulation is ongoing.