Vascular blowout syndrome (VBOS) secondary to neoplastic erosion is a dreadful complication of advanced stage malignancies that can compromise quality of life and overall prognosis in a fragile patient population. Endovascular therapy can offer minimally invasive, life-saving maneuvers both acutely and prophylactically. Four patients with end-stage malignancies eroding into various peripheral vascular beds with impending, threatened, and acute VBOS underwent successful endovascular management. Technical success was achieved in all patients with no perioperative morbidity or mortality. In all patients, endovascular intervention controlled life-threatening hemorrhage and facilitated adjunctive therapeutic modalities such as surgical tumor debulking and/or chemoradiation. In conclusion, our small case series demonstrates that endovascular therapy can offer safe and effective palliation of peripheral VBOS secondary to neoplastic erosion.