[A thromboembolic event rarely occurs alone].

A 65-year-old female patient presented to the emergency department with a history of progressive bilateral leg weakness. Her medical background included arterial hypertension, morbid obesity, and nicotine abuse.On clinical examination, the patient exhibited flaccid paraparesis without palpable foot pulses. Subsequently, the patient developed acute hypoxemia. CT angiography revealed an acute Leriche- syndrome with complete occlusion of the abdominal aorta and iliacal vessels, along with bilateral pulmonary embolisms.Therapeutic anticoagulation was administered and emergency thrombectomy performed. The patient was managed in the intensive care unit due to cardiogenic and hypovolemic shock resulting from reperfusion syndrome and pulmonary embolism. Despite, she died from subsequent complications.Acute Leriche syndrome refers to occlusion of the aortoiliac segment. The clinical mnemonic "the 6 P's" (paresthesia, pulselessness, pallor, pain, paralysis, and prostration) aid in recognizing acute limb ischemia. Notably, a sensomotor deficit may be the sole initial symptom. Prompt revascularization is essential; however, mortality remains high due to associated complications.