Objective To present and summarize the data concerning the treatment and prognosis of acute limb arterial embolism in West China Hospital. Methods Forty three patients with 52 limbs of acute arterial embolism were treated in West China Hospital from January 2003 to March 2006. There were 15 males and 28 females, aging from 26 years to 77 years 〔(58.88±13.90) years〕. The diagnosis was based on clinical manifestations and results of color Doppler sonography or DSA. The follow-up ranged from 1 month to 39 months. The following factors, which might influence the prognosis, were analysed through multiple linear regression of SPSS 10.0: age, sex, uper limb or lower limb, location of embolus, ischemic time, clinical categories of acute limb ischemia, history of smoking, atherosclerosis and other combined diseases, pervious history of acute limb arterial embolism, operative or nonoperative treatment, and postoperative complications. Results Clinical categories of acute limb ischemia include: Ⅰ (n=0),Ⅱa (n=16), Ⅱb (n=29), Ⅲ (n=7). The ischemic time varied from 3 h to 2 weeks. The sources of embolus: heart (n=39), vessle (n=7), iatrogenic origin (n=1), unidentidied origin (n=5). The therapies included embolectomy (n=38), catheter-directed thrombolysis (n=2) and medical treatment (n=12). The following postoperative complications occured: compartment syndrome (n=12), respiratory failure (n=3), alkalolsis (n=3), acute renal failure (n=2), wound infection (n=2) and pulmonary infection (n=1). Two patients died of cerebral infarction in hospital and one patient died of heart failure 3 months after discharge. Thirty-eight patients with 45 diseased limbs were followed up. The results were excellent in 13 limbs, good in 15 ones, fair in 8 ones and poor in 9 ones. The statistically significant influencing factors of prognosis include ischemic time, clinical categories of acute limb ischemia and history of smoking (P＜0.05). Conclusion The operation of embolectomy is the main treatment of acute limb arterial embolism. In selected patients, catheter-directed thrombolysis and medical treatment could be used to alleviate the limb ischemia. The treatment against the etiological factors should not be ignored. The prognosis of this disease could be influenced by ischemic time, clinical categories of acute limb ischemia and history of smoking.