Two patients sustained the rare complication of skin infarction following administration of intravenous streptokinase for acute myocardial infarction. We report evidence that dissolution of thrombus from an unsuspected source and subsequent microembolization of the skin may be responsible for this complication. In patients known to have an aortic aneurysm or ventricular thrombus, careful consideration should be given to the use of intravenous streptokinase following myocardial infarction.