Unintentional intraarterial injections are rare but may have devastating consequences. No consensus on treatment has been established owing to the wide variety of possible injected substances, incomplete understanding of the underlying pathophysiology, and the absence of case-controlled, prospective human studies. The aim of the present study and literature review was to evaluate the benefit of intraarterial thrombolysis combined with systemic anticoagulation therapy when an artery of the upper extremity is accidentally punctured and ischemia of the hand ensues.