Purpose: Acute iliofemoral deep vein thrombosis (aIFDVT) carries risks of pulmonary embolism (PE) and post-thrombotic syndrome (PTS). The Inari range of mechanical and suction thrombectomy offers a wide range of options for primary and in-stent aIFDVT. Methodology: Retrospective analysis of 12 patients with aIFDVT treated between 2023 and 2025 using Inari ClotTriever or FlowTriever. All followed a standardised antithrombotic and surveillance protocol. Primary outcomes included technical success, symptom improvement, and peri-procedural complications. Results: Twelve patients (mean age 65, 54% female) were included. PE was present in 54% of cases, with 60% of these cases being treated during the same admission. 40% had a previous stenting history (10% for PTS and 30% for aIFDVT), with a median stent age of 6 years (range, 2-8 years), and one of these required re-stenting. Of the primary aIFDVT, four required stenting, and 2 were tumour thrombi. ClotTriever was used in 5 cases, FlowTriever in 3, and both in 4 cases, with 3 cases using adjunctive ProTrieve embolic protection. Technical success was 100%. The mean operative time was 118 minutes, with an estimated blood loss of 20 mL. The mean postoperative stay was 3 days (range, 0–17 days). One procedural complication (8%) occurred with a PE that was managed intraoperatively. There was no access site thrombosis or bleeding. Clinical success was achieved in all patients, with 100% reporting symptom improvement. Primary patency at median 6-month follow-up was 92%; secondary patency was 100%. One reintervention occurred due to stent thrombosis linked to non-adherence with anti-coagulation. Villalta scores at 3, 6, and 12 months were <5. Conclusion: The Inari system offers a wide range of options for acute iliofemoral DVT, including primary, in-stent, and tumour thrombus scenarios.