Acute lower extremity ischemia secondary to fecal impaction has not been previously reported. Herein, we report the case of an elderly man who was referred to our medical center with an acutely ischemic right lower extremity and a possible abdominal aortic aneurysm. The suspicious abdominal mass noted by his local physician was found to be a large fecal impaction of the rectosigmoid which, by direct pressure, was compressing and occluding the right common iliac artery. After disimpaction, there was complete resolution of the vascular symptoms and signs in the right lower extremity.