Thromboangiitis obliterans (TAO) is often misdiagnosed and hence, there is enormous suffering by patients. Surgical options are limited in the
management. Most of the drugs used for medical management do not alleviate pain or help in the healing of ischemic ulcer. Chemical lumbar
sympathectomy (CLS) can help patients by relieving pain and improving blood flow to the affected area. It is a therapeutic option performed
under local anesthesia with relatively less morbidity. Although the drugs used can cause neuritis, sympathectomy is a better option. Proper
diagnosis and accurate neurolytic block helps in relieving patient suffering. A 30-year-old chronic smoker diagnosed to have TAO of the right
lower limb underwent CLS with alcohol. The patient had good pain relief.