In this episode, we explore Acute Peripheral Arterial Occlusion (APAO), a critical vascular emergency characterised by a sudden decrease in limb perfusion that threatens tissue viability. We break down the classic "6 Ps" of clinical presentation—pain, pallor, pulselessness, paraesthesia, paralysis, and poikilothermia—and review the latest 2024 guidelines on revascularisation strategies, ranging from catheter-directed thrombolysis to mechanical aspiration thrombectomy. Finally, we discuss the management of complications such as reperfusion injury and the necessity of early fasciotomy to prevent limb loss.