Buerger's disease is a distal vascular occlusive disease primarily affecting those with a history of tobacco use. Treatment of digital pathology can be quite difficult as a result. This paper discusses a patient who developed an ulceration of the left hallux that did not respond to local wound care and antibiosis. A lumbar sympathectomy was performed in conjunction with a hallux amputation to promote distal vasodilation and enhance the patient's ability to heal.