ABSTRACT: Purpose. Internal iliac artery occlusion can be an intentional or inadvertent complication of endovascular aneurysm repair, especially repair of abdominal aortic aneurysms (EVAR). Several studies have reported on side effects experienced by patients as a result of bilateral internal iliac artery occlusion, with buttock claudication and erectile dysfunction being the most frequent. A low incidence of serious side effects, including colonic and spinal cord ischemia, have been reported. In our study, we add the experience of 7 patients who underwent bilateral internal iliac artery occlusion at our institution in conjunction with endovascular repair of aneurysms of the abdominal aorta or common iliac arteries. Methods. A retrospective chart review was performed on patients who received embolization or experienced inadvertent occlusion of both internal iliac arteries. Patients were also contacted by phone and were asked about their experience with the procedures. Data regarding the incidence and severity of side effects as experienced by patients were compared to that obtained from published studies. Results. Between May 2000 and May 2010, 7 patients underwent procedures resulting in bilateral occlusion of the internal iliac arteries. Four of 7 patients (57%) experienced initial buttock claudication following the procedures; of these, claudication resolved by 18 months in 2 of 4 patients. Two of 7 patients (29%) reported experiencing new-onset impotence following the embolization procedures. There were no incidences of colonic or spinal cord ischemia. Conclusions. Bilateral internal iliac artery occlusion appears to have an acceptable incidence of side effects, with buttock claudication being the most common negative symptom.