Ergot-containing medications are widely used to treat migraine patients in some countries but nowadays intoxication is only reported rarely. We report a 35-year-old woman who presented with acute paresthesia of the extremities. An angiogram revealed diffuse vasospasm of the femoral arteries bilaterally and the right brachial artery. History taking disclosed a possible interaction between ergotamine and macrolide antibiotics. The patient's symptoms improved rapidly after discontinuation of the offending medication and administration of vasodilators. This report aims to remind physicians that catastrophic adverse effects can develop through unrecognized drug interactions, even with widely prescribed medications given in safe dosages. The importance of a detailed drug history and knowledge of drug interactions cannot be overemphasized in the diagnosis of ergotism.