Atheroembolism, a systemic vascular disease. Cholesterol crystal embolization (CCE) is an infrequent but serious disorder that is often an unrecognized medical problem. CCE may occur spontaneously from eroded atherosclerotic plaques or most frequently following procedures such as angiography, angioplasty, cardiac catheterization, anticoagulant therapy and aortic surgery. CCE predominantly affects elderly males with a frequent history of hypertension, atherosclerotic vascular diseases and renal insufficiency. CCE may result in protean clinical manifestations and may produce a spectrum of functional impairment. Confusion over the disease's natural history arises because the difficulty of establishing an antemortem diagnosis, and because the laboratory findings are non-diagnostic and non-specific. The mortality was 81% and the causes of death was most often due to multiorgan failure especially renal involvement. The definitive diagnosis depends upon finding the presence of intravascular cholesterol crystal in biopsy or autopsy specimens. The skin, muscle and kidney were the three most common sites for obtaining a premortem diagnostic biopsy.