This is a case of a 28-year-old female presented with an extensive cutaneous gangrene of her fingers and toes with history of a livedo reticularis rash in both lower limbs. Her work-up showed positive serology for Systemic Lupus Erythematosus (SLE). There were no other symptoms suggestive of SLE. Interestingly, the patient adequately responded to rituximab therapy. Such a case of digital gangrene as the initial presentation of SLE without secondary antiphospholipid syndrome has rarely been reported in the literature.