Thromboangiitis obliterans (TAO) also known as Buerger’s disease is a nonatherosclerotic vasculitis that is more common in adult male smokers. TAO predominantly affects lower extremities, however, cases with bilateral upper extremities involvement are a rare entity and difficult to manage. Symptoms of the disease mostly mimic that of acute ischemia of the limb. Diagnosis is mostly made clinically, however, radiographic vascular evaluation can strengthen the diagnosis. Herein we present a case of a 41-years-old male with a history of chronic smoking whose signs and symptoms were suggestive of TAO in bilateral upper extremities, however, the patient did not respond to smoking cessation and pharmacotherapy for a long time owing to which he underwent amputation after taking proper informed consent.
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