en 23926534 Background: Symmetrical peripheral gangrene is usually associated with underlying medical problems and it is seldom seen in pregnancy. Sepsis though common in a setting of delivery by unskilled midwife is rarely accompanied by symmetrical gangrene. Case Presentation: We report a case of symmetrical peripheral gangrene which occurred in the winter, triggered possibly by sepsis and a single dose of ergot. A high index of suspicion, early diagnosis and intervention with appropriate measures will result in favorable outcome in such cases. Conclusion: Although postpartum period is of high risk for sepsis and use of ergot alkaloids is common in labor but occurrence of peripheral symmetrical gangrene is rare. A high index of suspicion for the diagnosis and timely intervention will prevent irreparable damage and loss of limb. Ergot, Peripheral symmetrical gangrene, Postpartum 117 120 https://www.jri.ir/article/502 https://www.jri.ir/documents/fullpaper/en/502.pdf LipiSharmaDepartment of Obstetrics and Gynecology, University College of Medical Sciences and Associated Guru Teg Bahadur Hospital, Shadara, IndiaLipiSharmawww.lip.sharma14@gmail.com1006SumitaMehtaDepartment of Obstetrics and Gynecology, University College of Medical Sciences and Associated Guru Teg Bahadur Hospital, Shadara, IndiaSumitaMehta1007ShaliniRajaramDepartment of Obstetrics and Gynecology, University College of Medical Sciences and Associated Guru Teg Bahadur Hospital, Shadara, IndiaShaliniRajaram1008RachnaAgarwalDepartment of Obstetrics and Gynecology, University College of Medical Sciences and Associated Guru Teg Bahadur Hospital, Shadara, IndiaRachnaAgarwal959SanjayGuptaDepartment of Surgery, University College of Medical Sciences and Associated Guru Teg Bahadur Hospital, Shadara, IndiaSanjayGupta1010NeerjaGoelDepartment of Obstetrics and Gynecology, University College of Medical Sciences and Associated Guru Teg Bahadur Hospital, Shadara, IndiaNeerjaGoel1011