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This review aims to explore the HawkOne atherectomy (Medtronic), a single use directional atherectomy device, explaining in depth its indication, selection, preparation and application. It further provides techniques and tips to troubleshoot the device upon its use. Further, a review of the current evidence for directional atherectomy in the infra-inguinal arteries is conducted. Identifying that directional atherectomy in the infra-inguinal arteries allow for significant plaque modification and lumen gain without the use of barotrauma from balloon angioplasty. Highlighting that directional atherectomy had a lower incidence of flow limiting dissections and need for stenting after such treatment.