Persistent sciatic artery (PSA) is a continuation of the internal iliac artery into the popliteal-tibial vessels and this structure provides the major blood supply to the lower limb bud during early embyrologic development, Its remnants participate in the formation of the inferior gluteal, deep femoral, popliteal, peroneal and pedal vessels. When the femoral artery develops, the PSA then involutes. In rare circumstances it persists and so provides the only major blood supply to the lower limb. The PSA was first reported by Green in 1832 and until now, only about 100 cases have been reported in the world literatures. This rare vascular anomaly is associated with aneurysmal formation in 15% to 46% of cases and it has a bilateral location in 22% of PSA cases. In more than 40% of cases, PSA is asymptomatic. When present, such non-specific symptoms as gluteal pain and painful buttock mass are presented. However, the most frequent clinical finding is lower limb ischemia because in 25% of such cases, the presented symptoms are limb threatening. We describe here the case of a 54 year-old female affected with PSA occlusion, and she was treated with a combination of thrombolysis and thromboembolectomy.