Calcific uremic arteriolopathy is a rare and devastating disorder characterized by diffuse calcification of medium size arterioles and occasionally affects patients with chronic kidney disease. A 62-year-old woman with diabetes mellitus, arterial hypertension and moderate to severe chronic kidney disease was admitted to the hospital with multiple, non painful, necrotic, hemorrhagic and purulent chronic open wounds ranging from 1 cm to 3 cm of diameter in the medial and posterior aspects of both lower extremities. Sensation to light touch and vibration were absent in the lower extremities. Biopsy of a one of the lesions showed fat necrosis and extensive dystrophic calcific deposits in the subcutaneous fat and the wall of small arterioles, consistent with systemic calcific uremic arteriolopathy. Once the lesions ulcerate and grow proximally survival is unlikely.