Cholesterol embolism is a clinical syndrome in which cholesterol crystals break from an athero­matous plaque in a larger artery and occlude the lumen of small peripheral arteries. It com­monly occurs after vascular intervention procedures, but can also occur spontaneously. Because of possible involvement of any organ system, the syndrome represents a diagnostic challenge. In clinical presentation, the most commonly involved organs are the skin (in the form of blue toe syndrome or livedo reticularis) and kidneys (acute kidney failure), and there may also be abdominal pain. Patients are usually older and have generalized atherosclerosis, with or without its well-known manifestations. The diagnosis is more easily made when an embolism occurs acutely rather than when they are chronic. The diagnosis can be confirmed only by biopsy of the affected area that shows cholesterol crystals in the lumen of small arteries. Mortality from cholesterol embolisms is high, and their treatment is only symptomatic, aimed at slowing the progress of atherosclerosis.