A 14-year-old girl presented with a progressively cold, pale foot. Pedal pulses were absent and there was sensory and motor loss. CT angiography revealed a thromboembolic occlusion of the crural arteries and a popliteal artery entrapment. Following thromboembolectomy with popliteal artery patch angioplasty and release of the gastrocnemius muscle, the girl fully recovered.