OBJECTIVE To describe a case of acute limb ischemia caused by arterial thrombosis due to coronavirus disease 2019. METHODS Clinical observation of a patient. METHODS Academic medical center. METHODS A 59-year-old female with history of hypertension, hyperlipidemia, and prior smoking. METHODS Clinical observation and data extraction from electronic medical records. RESULTS We report a case of peripheral arterial thrombosis associated with coronavirus disease 2019, resulting in acute limb ischemia of the right lower extremity. This event was heralded by a sudden and significant elevation in d-dimer levels. At the time of surgery, a long, gelatinous clot was retrieved from the right popliteal artery. Perioperatively, she continued to have absent pedal Doppler signals and after multiple embolectomy attempts, required distal arterial cut down with removal of additional thrombi and resultant improvement of distal arterial flow. CONCLUSIONS This case demonstrates the importance of regularly checking d-dimer levels and vigilant monitoring for arterial thrombotic events, as they can rapidly become catastrophic.