Objective To evaluate the clinical effectiveness of catheterization via the popliteal vein for thrombolysis in acute deep vein thrombosis of lower extremities. Methods Patients with documented acute lower extremity deep vein thrombosis were divided into two groups. Patients in group A received CDT with venous access through the ipsilateral popliteal vein. The patients in group B received CDT via the ipsilateral popliteal vein. Clinical efficacy was evaluated by measuring the circumferences between the normal and affected limbs before and after treatment; the venous patency score, the rate of patency improvement based on venographic results, and the clinical results including the limbs edema reduction rate, the mean complications; were all compared between the two groups. Results The limbs edema reduction rates of thigh were [(88?±?13) VS (85?±?22) %], those of leg were [(82?±?16) VS (84?±?15) %], likewise, the rates of venous patency improvement were [(84.55?±?2.34) VS (84.52?±?3.24) %]. There was no significant difference in efficacy between the two groups (P?>?0.05). The course of treatment in group A was shorter and the dosage of urokinase was less compared with group B (P?