Abstract Background Limb gangrene in neonates is an extremely rare clinical problem and very few cases have been recorded up to now. The clinical findings were mild involvement of skin to full necrosis and gangrene of the involved regions. Unfortunately, in most cases the etiology cannot be established. However, a variety of etiological causes may account for this condition. Case Presentation We present a newborn baby with symmetrical peripheral gangrene of the limbs, both flanks, chin, and scrotum due to leukocytoclastic vasculitis with unknown cause. He was treated by parenteral glucocorticoid, broad-spectrum antibiotics, heparin, hydralazine and fresh frozen plasma (FFP). He died after 2 weeks of intensive treatment. There is history of the same disease in two infants of his paternal aunt, both of them were dead soon after birth. Conclusion Peripheral gangrene with symmetrical involvements, due to vasculitis, is a very unique disorder in newborn infant, which no case was reported up to now.

Keywords: Neonates, Leukocytoclastic Vasculitis, gangrene