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High-voltage electric injury is frequently complicated by significant long-term sequelae. Vascular lesions following electric injury include thrombosis, pseudoaneurysm formation, and spontaneous rupture. These complications have previously been believed to be confined to smaller vessels. Damage to the vessel walls contributes to the progressive tissue loss and necessity of extremity amputation that characterize a large percentage of these cases. A patient is discussed who sustained a highvoltage electric injury, followed by late abdominal aortic occlusion with distal embolization. The patient required multiple vascular reconstructive procedures and ultimately a below-knee amputation.