Arterial injury after total hip arthroplasty is rare, but the consequences of this complication are serious and potentially life-threatening. Here, we report a case of delayed-onset common femoral artery occlusion after total hip arthroplasty that was performed via the posterior approach at Siriraj Hospital-dThailand's largest university-based national tertiary referral center. Our case was successfully treated with arterial thromboembolectomy. We postulate that anterior retractor placement caused intimal injury to the vessel. Routine monitoring of postoperative vascular pulse is essential. Early detection and prompt vascular surgeon consultation are the important factors for preventing the potentially catastrophic consequences of this complication.