Unusual clinical course Background:Deep vein thrombosis (DVT) is a potentially fatal condition that occurs in 100 persons per 100 000 population, and accounts for 60 000 deaths per year in the United States, making its evaluation and diagnosis essential. Diagnosing DVT can be challenging due to symptom variations between patients. There are no previous reports of DVT patients presenting with foot drop in the literature. Therefore, the purpose of this case report is to present an unusual presentation of DVT in a middle-aged man with no clearly identifiable risk factors for DVT. Case Report:A 54-year-old otherwise symptom-free male smoker (for 30 years) presented to the Emergency Department complaining of pain in the left leg, which then escalated to weakness and decreased sensation in the left foot. However, he was able to walk with limping. Upon his presentation to the Emergency Department, he stated that his left leg felt quite weak. The neurological examination did not show any remarkable results, except for unilateral limb weakness. After that, a point-of-care ultrasound was carried out, which showed the possibility of non-compressible veins; then, a D-dimer test was conducted. When it tested positive, an official ultrasound was done, which showed thrombi in the left external iliac and common and superficial femoral veins. Conclusions:This study reported a unique presentation of foot drop due to DVT in a middle-aged man, with the absence of known risk factors. Utilizing point-of-care ultrasound is a valuable tool in the evaluation of acute unilateral lower limb weakness.