We describe a 57-year-old woman who developed permanent acrocyanosis of all fingers rapidly leading to distal necrosis, revealing an ovarian cancer (OC). Seven similar published cases are reviewed. Digital ischaemia was bilateral, severe and frequently complicated by digital necrosis. OC was of epithelial origin and disseminated at the time of diagnosis. Initial treatment of OC usually resulted in improvement of digital ischaemia. A possible OC should be looked for in women aged 45 years or more presenting with severe digital ischaemia of recent onset.