Symmetrical peripheral gangrene (SPG) is defined as ischemia of two or more than ttvo extremities without the existence of a major vein occlusion. A 78-year-old female patient teas admitted to the intensive care unit because of hypertension, chronic obstructive lung disease, congestive heart disease, and cerebrovascular attack. The patient, stayed hypotensive in spite of high-dose vasopressor treatment. After the development of sepsis and DIC, fast-developing gangrenous necrosis ivas observed which was most, apparent in the right foot and in the 1st, 2nd, and 3rd distal digits of the right, hand. Infusion of noradrenaline and other vasopressor agents was gradually tapered and stopped. Intensive fluid replacement with dekstrane 40.000 and pentoxifylline ivas administered for SPG treatment. Cyanotic appearance of the foot disappeared, but dry gangrenous forms in the right hand became permanent. The patient died due to multiple organ failure on the 18th day of her intensive care stay.