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Leriche's syndrome represents an arterial occlusion of the aortic bifurcation with ischaemic symptoms of both legs. A case of Leriche's syndrome as a complication of end stage renal failure has not yet been reported in the litarature. A 50-year-old woman was taken into the emergency service with severe abdominal and leg pain, loss of movement of both legs, and dyspnoea. On physical examination, there was abdominal tenderness, coldness and pallor of both legs, and pulselessness of the upper and lower extremities. No flow was seen in either femoral artery with superficial ultrasonography probe in the emergency department. Dynamic thorax and abdominal computed tomography was planned and total occlusion of the infrarenal level of the abdominal aorta was detected. Within the first hour of the diagnosis of acute thrombosis of the aorta bifurcation, bilateral femoral embolectomy was performed by the Cardiavascular Surgery Clinic. After 1 week, the paitent was discharged without any complication. Chronic renal disease patients, especially those referred to the emergency department with acute complaints, must be evaluated carefully and quickly, primarily for cardiovascular diseases. Principally, infrarenal aortic occlusion must be considered and femoral pulses must be examined in the differential diagnosis for patients presenting with paraplegia and severe pain. [ABSTRACT FROM AUTHOR]