Stenting of femoropopliteal (FP) arterial disease is currently the most common strategy adopted by endovascular specialists. Several randomized trials have shown that stenting with nitinol self-expanding stents leads to less restenosis on intermediate-term and long-term follow-up when compared with plain old balloon angioplasty (POBA) and provisional stenting. In this overview, we present the pros and cons of primary stenting of FP arteries vs alternative approaches including provisional stenting following POBA, atherectomy and/or drug-coated balloons, and how these initial non-stent strategies play a significant role in treating FP arterial disease.