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In the present report, we have described the use of intravascular lithotripsy angioplasty for heavily calcified occlusions of the infrarenal aorta and its bifurcation in two patients. In the first patient, two lithotripsy balloons in kissing conformation were simultaneously used to allow for dilatation of the distal aorta and its bifurcation with preservation of accessory renal artery patency, followed by stenting of the iliac arteries. For the second patient, the infrarenal aorta occlusion was first treated with a single lithotripsy balloon, followed by covered stenting. Intravascular lithotripsy could represent a valid endovascular adjunct to optimize outcomes in the treatment of coral reef aortas and aortic bifurcation occlusion.