HIV carries significant morbidity and mortality around the world even after 40 years since its detection and improvement in management strategies. Anti-Retroviral Therapy (ART) has improved the lifespan and quality of life of HIV/AIDS patients. However, both HIV and ART are associated with several cardiovascular complications. HIVrelated vasculopathy is one of the rarer cardiovascular complications. We present a 46-year-old female patient, a known case of HIV/AIDS on ART, who came with peripheral limb ischemia and went on to develop gangrene of the limb. Her CD4+ count was 374. She was managed with systemic thrombolytic therapy and other symptomatic and supportive treatment, but recanalization could not be achieved and unfortunately, she had to undergo an above-knee amputation. The purpose of this presentation was to highlight the existence and implication of HIV vasculopathy in patients with HIV