Background: Idiopathic thoracic aortic mural thrombi are rare. They can be responsible for dramatic systemic embolization. Early treatment is imperative because of their high morbidity and mortality rate.
Case presentation: A 55-year-old previously healthy Moroccan male came in an array of acute right lower limbs pain and abdominal sensibility. Severe systemic embolism involving the lower extremities, spleen, kidney, and digestive tract, due to an idiopathic mural thrombus of the thoracic aorta was diagnosed. He received medical treatment leading to the complete disappearance of the thrombus and the effects caused by the latter.
Conclusions: When faced unexplained peripheral embolization, research for a thrombus of the thoracic aorta should be performed. Medical treatment should be considered for its management, especially in patients with high surgical risk.