A fit and well 29-year-old man underwent a right above-knee amputation in 1976 as a result of severe trauma sustained in a road traffic accident. After rehabilitation, he remained well and mobilized independently with his prosthesis. Twenty nine years later he was admitted to hospital for an infection of his stump following minor trauma. There was no history of diabetes, hypertension or smoking. He was taking aspirin and lipid-lowering medication. During his admission and subsequent follow up, he gave a clear history of not only right stump (thigh) claudication but also claudication in his absent right calf when mobilizing with his prosthesis after walking 50 yards. The pain was relieved quickly by ceasing to walk. The claudication persisted after the stump was well healed. At re-presentation, both the arterial duplex scan and magnetic resonance angiogram showed occlusion of the right external iliac artery (Figure 1). His stump healed well with no surgical intervention or complication. He was advised to exercise to improve the claudication. After 4 months he was able to walk 100 yards without claudicating.