Aortoiliac occlusive disease is the narrowing or blockage of the main arteries in the pelvis, which supply blood to the legs. It is a type of peripheral arterial disease.Atherosclerosis, the hardening of the arteries that occurs when fatty plaque builds up inside artery walls, causes aortoiliac occlusive disease.The primary symptoms of aortoiliac disease are pain, cramping, tightness, numbness, or tiredness in a person's hips, thighs, or buttocks when he or she walks or exercises. These symptoms stop when the person is at rest.