The changing landscape of thrombolytic drugs used for treating peripheral occlusive disease has spurred increasing use of mechanical thrombectomy devices (MTDs). These devices comprise a variety of tools intended to remove, fragment, or disperse thrombus in veins, arteries, or bypass grafts. Although most devices are U.S. Food and Drug Administration approved for use in occluded hemodialysis access grafts, only one, the AngioJet device, is currently approved for use in peripheral arterial applications. Nevertheless, most devices have been used for this off-label application, and clinical centers have published their results. This article reviews the distinguishing features of current mechanical thrombectomy devices, as well as the currently available literature reporting on their use in peripheral arterial occlusions.