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Endovascular management of deep venous thrombosis (DVT) is complex due to heterogeneous patient populations with several distinct clinical subgroups with different management recommendations. Endovascular intervention is a rapidly evolving field with new devices and techniques entering the market. Early, proactive thrombus removal restores in-line flow within the deep venous system and improves acute DVT-related symptoms. Long-term effects on post-thrombotic syndrome (PTS) and venous-related quality of life are still not proven. Recent trials have helped to identify which patients may benefit from intervention, but more work is needed to produce more generalizable results, refine patient selection, and identify risk factors for PTS. Endovascular interventions for DVT are dependent on the location, extent, etiology, and clinical presentation of DVT and should be utilized on an individualized patient basis.