A cute limb ischaemia (ALI) is a disease that carries with it a high morbidity and mortality. It is a time-critical disease process; the best outcomes are seen when patients are rapidly diagnosed and referred immediately to a vascular surgery unit. Unfortunately, if the diagnosis is missed or delayed, this puts the patient at high risk of irreversible limb loss and amputation. The aim of this article is to cover the aetiology, diagnosis and management of ALI, mainly from a primary care level, along with secondary care management options. The GP curriculum and acute limb ischaemia From the GP curriculum there are three main areas that list the learning objectives that are relevant for GPs treating patients with acute limb ischaemia: Clinical module 3.01: Healthy people: Promoting health and preventing disease, clinical module 3.03: Care of acutely ill people, and clinical module 3.12: Cardiovascular health. In particular GPs are expected to:. Demonstrate a reasoned approach to the diagnosis of cardiovascular symptoms using history, examination, incremental investigations and referral. Investigations you will be expected to understand and utilise including the 12-lead electrocardiogram and ankle-brachial pressure index measurement. Be able to manage cardiovascular conditions including: cerebrovascular disease, arrhythmias (atrial fibrillation being the most common), and peripheral vascular disease. Recognise the signs of illnesses and conditions that require urgent intervention. Promote cardiovascular well-being by applying health promotion and disease prevention strategies appropriately. Promote health through a health promotion or disease prevention programme Acute limb ischaemia (ALI) can be defined as a sudden loss of limb perfusion, leading to ischaemic tissue injury and the resulting risk of limb loss. Most cases of ALI are caused by thrombosis of a limb artery or bypass graft, embolism from the heart or a diseased artery, dissection, or trauma (Acar, Sahin, and Kirma, 2013). The incidence of ALI is around 1.5 cases per 10 000 people per year (Naidoo, Rautenback, and Kahn, 2013).