Popliteal artery entrapment syndrome (PAES) is an uncommon pathological entity, due to segmental popliteal artery compression by the surrounding myofascial structures. Clinical symptoms may appear acutely, with temporary ischemic attacks, or chronically, with claudicatio intermittens of the involved calf and for 30% bilateral. Treatment, generally, is surgical by simple freeing of the popliteal artery from the surrounding myofascial structures or by autologous vein (saphenous v.) interposition grafting and patching, or bypass without vessel resection. The case of a 44-year female with left calf acute pain symptoms, cold skin at the thermotouch, hypo-paresthesia with fifth toe cyanosis and walking inability is reported. The surgical treatment, because of early diagnosis, consisted of simple cut of myofibrous bundle starting from the medial head of the left gastrocnemious muscle and compressing the popliteal artery, with clinical complete resolution.
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