Objective: The purpose of this article is to review the role of imaging in the diagnosis, treatment, and follow-up of patients with sport-related flow limitations in the iliac arteries.

Conclusion: Endurance athletes can develop flow restriction during exercise because of endofibrosis or kinking of the iliac arteries. Knowledge of this entity and the use of appropriate imaging techniques are crucial for diagnosis. Imaging plays an important role in the assessment of the underlying lesion and its location as well as in posttreatment follow-up.