Background Critical illness from conditions such as Streptococcus Toxic Shock Syndrome can necessitate high concentrations of sympathomimetic pressors. Resultant vasopressor-induced ischemia of the hand is a severe complication of their life saving care. It can often result in digit necrosis and amputation with resultant poor aesthetic and functional outcomes. Currently, there are no widely accepted approaches for treating this cause of peripheral digital ischemia. Management ranges from no intervention in a “watch and wait approach” to early surgical arteriolysis. More recently, Botulinum Toxin (Botox) has been described for the treatment of vasospastic disorders of the hand and is known to effectively treat several disorders, including overactive bladder, cervical dystonia, and chronic migraines. Case Report This is a case report of the use of local injections of Dysport® for the treatment of digital ischemia in a septic ICU paediatric patient. It was utilised in a two year old with Streptococcus Toxic Shock Syndrome with digital ischaemia in all four limbs. We will discuss the outcomes as well as a suggested treatment protocol. Conclusion This case report will demonstrate the successful use of Botox in digital ischaemia in sepsis. We will discuss the outcomes as well as a suggested treatment protocol. There is further scope for use of Botulinum Toxin in digital ischaemia and an introduction of protocols in critical care settings.