Coral reef aorta is a rare type of atherosclerotic disease that causes severe calcification in the abdominal aorta.

We present a case of coral reef aorta with hemodynamically significant symptomatic aortic stenosis causing intermittent claudication and bilateral cyanosis of the toes.

Despite the challenging anatomy for endovascular treatment, the patient underwent successful transfemoral endovascular stent-graft placement.

The endovascular intervention with stents is a viable alternative method and, in many cases, constitutes the first choice for the treatment of coral reef aorta.