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Acute Limb Ischaemia (ALI) is a profound clinical emergency resulting in potentially devastating complications including limb loss and death. The commonest aetiologies of ALI are traumatic disruption of the limb arterial supply or their non-traumatic occlusion secondary to embolism or thrombosis. The resulting ischaemic tissue injury progresses rapidly culminating in irreversible nerve and muscle injury that eventually renders the limb unsalvageable. Hence, immediate identification and diagnosis followed by urgent revascularization offers the best chance of preventing permanent tissue injury and limb loss. Nevertheless, associated co-morbidity, metabolic derangement and potential reperfusion injury may pose a significant risk of mortality in patients who suffer ALI. Hence urgent assessment of limb viability followed by immediate and meticulous therapeutic intervention is needed to achieve optimal prognostic outcomes.