Cholesterol Embolization Syndrome (CES) is a systemic disorder due to cholesterol crystal embolization from atherosclerotic plaques of the aorta and its major branches to the small arterioles, resulting in local ischemia and organ damage. The diagnosis is mostly missed, especially in dialysis patients. There is no definite treatment available and the mortality is relatively high. We present a hemodialysis patient with cholesterol embolization syndrome who developed discoloration of the toes and necrotic ulcers after coronary angiography and whose diagnosis was confirmed with skin biopsy, and discuss the case with literature information.