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In this article, we report the case of a 43-year-old man with no significant medical history who was urgently referred to our imaging department for suspected acute ischemia of the right upper limb. Computed tomography angiography showed a lack of contrast progression in the proximal third of the radial and ulnar arteries, initially suggesting an arterial occlusion. However, distal pulses were palpable on clinical examination. Doppler ultrasound revealed a brachial vein thrombosis associated with significant lymphedema, likely responsible for transient arterial compression. This case highlights the importance of a multimodal diagnostic approach and reminds us that venous thrombosis can mimic arterial disease.