Cholesterol emboli usually occur in patients older than 50 years with a predilection in men and whites. Clinical presentation includes acute kidney injury, new onset hypertension, proteinuria that may be in the nephrotic range, hematuria, and occasionally increased eosinophils. Cholesterol emboli can involve all organs downstream of atherosclerotic plaques, including the lower extremities where it manifests as livedo reticularis. The kidney is the most common site of involvement, followed by the spleen, pancreas, gastrointestinal tract, and adrenal glands.