Minimal invasive techniques for fracture repair are becoming more prevalent as increased experience is gained by orthopedic trauma surgeons worldwide, with minimal invasive plate osteosynthesis (MIPO) surgery being a popular one. In the current case report we describe a rare complication of fracture management, where anterior tibial artery occlusion occurred as a result of direct pressure by an LCP 4.5 mm plate inserted via MIPO technique.