We report a case of a 42-year-old male with cardiomyopathy and acute bilateral femoral artery embolization. Following bilateral femoral artery embolectomy and fasciotomy, transthoracic echocardiography revealed a pedunculated highly mobile left ventricle (LV) thrombus. Surgical removal of the thrombi was not recommended for the procedural risk; consequently, anticoagulation therapy was recommenced. Unfortunately for the patient, the bleeding risk impeded the continuation of anticoagulation, which resulted in an increase in the thrombus size. The patient shortly developed multiorgan failure and possibly disseminated intravascular coagulopathy (DIC) and died. Besides this case, we have systematically reviewed the PubMed and Scopus databases for all the previously reported pedunculated thrombus/ thrombi cases.