Introduction Hand ischemia following vascular access surgery is an uncommon complication. A clinical dilemma exists between prioritizing the preservation of vascular access and the need for surgical intervention to rescue the ischemic hand. Report An 80 year old man who had hand ischemia following creation of a polytetrafluoroethylene arteriovenous graft with clinical evidence of ischemic pain of the left hand and Doppler ultrasound evidence of diastolic flow reversal is described. Far infrared therapy (FIR) was applied over the distal part of the affected limb, and the symptoms and signs of ischemia improved remarkably. Follow up ultrasonography also revealed the disappearance of diastolic flow reversal. Discussion FIR therapy is a promising and non-invasive therapeutic modality to treat vascular access related hand ischemia by decreasing vascular resistance and improving hand perfusion.