Aortic thrombosis is a rare condition that can be caused by atherosclerosis, aneurysms, thrombophilia, vasculitis, trauma, and malignancy. Symptoms vary based on thrombus size and site of embolization. It can lead to devastating complications including acute limb ischemia, myocardial infarction, stroke, and other target organ ischemia. Diagnosis is based on clinical presentation, imaging findings, and relevant laboratory work-up. Although not well defined, management for aortic thrombosis includes surgical intervention, such as thromboembolectomy, and conservative measures, such as anticoagulation. Here, we present a unique case of aortic thrombosis causing acute lower limb ischemia with elevated lipoprotein(a) and other comorbidities. Based on our literature review, our article is the first to establish the connection between elevated lipoprotein(a) and aortic thrombosis in the nonaneurysmal aorta.