Introduction: The risk of thrombosis is increased in hypercoagulability. Hypercoagulability can be inherited or acquired. Here, we want to present a patient with inherited hypercoagulability who came to the emergency department by walking and was diagnosed with total abdominal aortic thrombosis and acute renal artery thrombosis. Case Report: A 48-year-old female patient presented to our emergency medicine department with a history of right flank pain for 30 minutes. The pain had started abruptly and was continuous. She came to the emergency medicine department by walking. The contrast-enhanced abdominal computed tomography showed right renal infarction, right artery occlusion, and abdominal aortic thrombus at the level of the iliac bifurcation. Conclusion: Abdominal aortic thrombus is a relatively rare complication of hypercoagulability. Total occlusion of the aorta is generally presented with pain, pallor, weakness, and numbness of the lower limbs. In our case, there was none of these signs due to the blood flow supplied by collaterals. It is a challenge to diagnose total aortic occlusion in a patient that comes to the emergency department by walking.