Heparin-induced thrombocytopenia is an infrequent complication of heparin which causes thrombocytopenia and thrombosis. The vascular radiologist can expect to come across several cases in his/her career. A high index of suspicion is required for early diagnosis. This may befall the radiologist who is asked to provide thrombolytic treatment in a heparinized patient. We present such a case and discuss the clinical presentation, pathogenesis and management of heparin-induced thrombocytopenia.