An 18 years old female patient was given a test dose of Benzyl penicillin in the Antecubital Area on the right forearm by a staff nurse of the department. After the injection, the patient complained of severe pain in the right forearm distal to the injection site. This was followed by blanching of the right forearm and hand. She was immediately heparinised followed by other symptomatic treatments. After 12 hours, a bluish discoloration developed on the hand, both on dorsal and palmar aspect, sparing the thumb. This recovered with medication, except the late development of dry gangrene of the tip of distal phalanx of the little finger which got shrivelled later on. Color Doppler flow study, echocardiography, and CT angiography of the right upper limb were done. Understanding of the pathogenesis and prompt action can help in saving a limb. Education of the medical professionals involved in administering injection is necessary so that they become aware of abnormal course or anomalous anatomy of vessels of upper limb. This can help to prevent the complications.

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