In Iraq, Bullet injuries are one of the most surgical interests in emergency practice, especially nowadays. Many rarities and complications had been managed in a very restricted media of facilities and investigation tools.

Patient Presentation
A 30 years old male awakened from sleep at early morning complaining from sudden dyspnoea, hemoptysis and hematemesis. The patient was sleeping on the roof of his house exposed to the sky, which is a usual habit at Iraq at summer time.
After presentation, early emergency measures and admission, the patient developed right sided lower limb ischemia. Exploration of right femoral artery with removal of embolized bullet was done next day .

Results
No residual chest complications with smooth postoperative period and the patient discharged from hospital improving with still paretic limb with sensory deficit .
After one month follow up, plantar flexors were improved with better sensory responses.

Conclusion
In serious presentations we should not accept simple explanations, ischemia is such a serious matter that should not wait investigative measures to start management.