Purpose of Review <p>This review addresses the pathophysiology, clinical manifestations, and management of digital ischemia in autoimmune connective tissue disease (AICTD). Given the substantial morbidity associated with AICTD-related digital ulcers, prompt diagnosis and intervention are critical.</p> Recent Findings <p>Digital ulcerations, which often present in patients with AICTDs, affect nearly half of all systemic sclerosis patients and typically occur in the setting of Raynaud’s phenomenon. While traditional vasodilators such as calcium channel blockers and phosphodiesterase inhibitors constitute first-line therapies, emerging evidence supports the use of adjunctive botulinum toxin injections and intravenous prostacyclins for refractory cases.</p> Summary <p>Inpatient management of digital ischemia requires a multimodal approach, combining behavioral strategies with targeted pharmacotherapies. The recent incorporation of additional vasoactive therapies has augmented the therapeutic landscape. Further research is needed to optimize treatment protocols and establish long-term efficacy.</p>