Limb ischemia in pediatric population is a rare but potentially catastrophic event; it can lead to death of nerve and then muscle tissue within 4 to 6 hours unless the limb is revascularized. The most appropriate diagnostic and therapeutic strategy has evolved with emerging technologies inclusive of less-invasive endovascular diagnostic and therapeutic options. We report the case of a 5-year-old patient with acute limb ischemia (ALI), to illustrate the diagnostic and therapeutic approaches and the peculiarity in pediatric population.