Purpose:   This study evaluates the safety and efficacy of intravascular lithotripsy (IVL) in the management of Critical Limb Threatening Ischaemia (CLTI), particularly in the presence of heavily calcified below-the-knee (BTK) lesions, where traditional revascularisation is often limited by vessel calibre and compliance.   Methodology:   A retrospective, single-centre analysis was performed on nine patients with CLTI treated with IVL between 2023 and 2025. All had severe arterial calcification involving the infra-popliteal segments. Primary outcomes included procedural success, as measured by luminal gain and improved vessel compliance on IVUS, as well as complications including rupture, embolisation and vessel occlusion. Secondary outcomes included changes in Rutherford classification and vessel patency on duplex ultrasound.   Results:   IVL was successfully delivered in all cases. No adjunctive stenting was required. Six vessels were occluded. The mean luminal gain was 94.2% on IVUS. Increased vessel compliance was observed in all patients. No procedural complications were recorded. Primary patency was  100% of cases at 6-month follow up. Rutherford scores improved by a mean of 3.4 points.   Conclusion:   IVL is a safe and effective treatment for complex calcified BTK disease. These findings support its growing role in limb preservation strategies in CLI.