Symmetrical peripheral gangrene (SPG) has been reported in patients with a multitude of medical conditions such as DIC, infections, and use of vasopressors (eg, dopamine, epinephrine, or norepinephrine), to name a few. Among the infections, meningococcal, streptococcal, Escherichia coli, and pseudomonal infections have been reported to cause it. It is a rare but dreadful complication of septicemia, with a high mortality rate (up to 40%). About half of the patients who survive require amputation of the affected limb. Being sicker with asplenia, our patient was at risk of S aureus PF. Other aggravating factors include immunosuppression, diabetes mellitus, renal failure, and use of vasopressors. SPG should be suspected at the first sign of marked coldness, pallor, cyanosis, or pain in the extremity, as the condition can progress rapidly to frank gangrene requiring amputation. The ischemic changes begin distally and may progress proximally to involve the entire extremity. These changes are not ordinarily preceded by demonstrable peripheral vascular occlusive disease and may be associated in the early stages with intact distal pulses because the large vessels are often spared. Early recognition and immediate discontinuation, if possible, of vasopressor therapy (as it aggravates the low-flow state by enhancing vasoconstriction) and vigorous therapy for sepsis are essential components of SPG management.