Acute limb ischaemia is both a limb-threatening and life-threatening surgical emergency. The clinical presentation of acute limb ischaemia can vary depending on the underlying aetiology as well as pathophysiology. While traumatic acute limb ischaemia becomes obvious in a trauma victim, nontraumatic ischaemia can be easily mistaken for other neurological or medical conditions. The rapidity with which acute limb ischaemia causes irreversible muscle injury signifies the importance and urgency of accurate diagnosis. A high degree of clinical suspicion and accurate bed-side assessment can be pivotal in timely diagnosis and initiation of definitive care to maximize limb salvage.