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Abstract The aim of this study was to discuss causes of digital ischaemia. We report the case of a 29-year-old woman presented with an ischaemic involvement of two fingers of her right hand. She was a tobacco and cannabis user. Blood tests showed the presence of cryofibrinigenaemia. We discuss the putative causes of finger necrosis in this patient, that is, thromboangiitis obliterans (Buerger disease), cannabis arteritis and cryofibrinogenaemia. Cannabis arteritis is thought to be a particular form of thromboangiitis. Cannabis and contaminating arsenic have probably noxious arterial effects. In conclusion, cannabis arteritis should be considered in case of digital arteritis and search for cannabis use should be preformed in this case. Search for cryofibrinogenaemia could be useful in patients with digital ischaemia.