A healthy, 42-year-old woman presented to a local community hospital with abdominal pain and left arm pain after laser stone ablation and ureteral stenting performed earlier that day. She was diagnosed with a spontaneous aortic thrombus and embolization of the radial, ulnar and splenic arteries and transferred to a tertiary care facility for cardiothoracic surgery evaluation. This case report discusses her emergency department course, disposition, and one-year outcome.