Leriche Syndrome is a aortoiliac occlusive disease (AIOD) which is atherosclerosis affecting the distal abdominal aorta, iliac arteries, and femoropopliteal vessels [1]. Leriche Syndrome when symptomatic presents with a classical triad of claudication importance and absence of femoral pulses. In this article we discuss a case of 49-year-old female, a known case of Rheumatic Valvular Heart Disease with mitral stenosis, post mitral valve replacement (prosthetic mitral valve in situ), who presented with complains of sudden onset weakness of both lower limbs associated with tingling and numbness. On examination, femoral and peripheral vessels were not felt. Hereby, this article is about Leriche Syndrome in a patient of Rheumatic Valvular Heart Disease with post mitral valve replacement presenting as acute paraplegia.