Thromboangiitis obliterans (TAO), otherwise known as Buerger's Disease, is a rare, small-vessel vasculitis strongly associated with cigarette smoking, that when left untreated can cause vessel destruction and necrosis of the distal extremities leading to amputation. The patient being presented is a 46-year-old Caucasian female who has been smoking since the age of fifteen and shows characteristics of TAO on angiography. The uniqueness of this case lies in the epidemiology; the typical TAO patient is a 20 to 40-year-old Asian male. However, over the last few decades, the typical patient population for TAO has been shifting. Our patient represents this changing demographics of TAO patients that include a greater percentage of women, non-Asian ethnicities, and the elderly. This patient represents an opportunity to follow the disease progression and learn more about the pathophysiology of TAO as it pertains to its shifting demographics.