Upper limb ischemia (ULI) is relatively infrequent when compared to lower limb and accounts for less than 5 % of all extremity ischemia. ULI can be related to a broad spectrum of different etiologies that might require specific therapeutic interventions. Regardless of the etiology, a high index of suspicion and low threshold to initiate treatment are essential for limb salvage. Large arteries proximal to the wrist are rarely affected while small distal vessels are involved in the majority of cases, comprising around 90 % of all ULI.