Acute total occlusion of the aorta is a critical and rare disease, and it may be difficult to differentiate its symptoms from those of other abdominal diseases. Early diagnosis of the condition requires a high index of clinical suspicion and delays in diagnosis and treatment contribute to poor results and high mortality. We report an 85-year-old male who had left lower leg tenderness for several days. Upon admission, acute abdominal tenderness was found and acute total occlusion of the aorta with mesenteric ischemia was suspected. The patient expired less than 6 hours after being diagnosed.