Cholesterol embolization syndrome (CES) is a multiple systemic disease caused by the embolization of cholesterol crystals from an atherosclerotic plaque of a proximal large-caliber artery, which results in the occlusion of distal small to mediumsized arteries. CES is characterized by development of a multitude of small emboli over time, and should be distinguished from arterial thromboembolism, which occurs through the obstruction of medium-sized to large arteries by one or a few large emboli. We report on a case of CES initially presenting as acute limb ischemia following an intervention for iliac artery occlusion.