Chronic limb-threatening ischemia is a significant source of morbidity, amputation, and mortality. Although many patients are candidates for endovascular or surgical bypass therapies, an increasing number of patients are not amenable to these procedures. Percutaneous lumbar sympathectomy is a minimally invasive procedure that has been associated with improvements in patients’ pain and ulcer healing. This report describes a case of computed tomography-guided lumbar sympathectomy for palliative treatment of severe rest pain in a patient who was not a candidate for either open or endovascular treatments, which resulted in successful palliation of the patient’s symptoms.