Symmetrical peripheral gangrene (SPG) is a relatively uncommon clinical entity manifested by distal ischemic damage at two or more sites in the absence of large vessel obstruction. Here we report a case of SPG due to osteomyelitis with concurrent dry gangrene of the penis. Osteomyelitis is a rare cause of SPG and, to the best of our knowledge, SPG with dry gangrene of the penis has never been previously reported.