Intra-aortic balloon pump (IABP) is a bridge to definitive management in a patient with compromised systolic function. It is a life-saving mechanical support to the failing myocardium. It is a procedure that should be employed judiciously with utmost caution. In this correspondence, we aim to highlight a rather serious complication associated with IABP use. A patient with triple vessel disease was posted for coronary artery bypass grafting with poor left ventricular function (ejection fraction 30%) and previous myocardial infarction 4 months back. An IABP was inserted in the left femoral artery following which he developed irreversible ischemia of the left lower limb leading to amputation of the limb. This catastrophic complication is one of the most dreaded impediments in the use of IABP. The clinician needs to weigh the pros and cons carefully and employ this vital procedure only when its use is explicitly justified.