The purpose of this case study is to investigate the regenerative healing capabilities of acellular dermal matrix when applied to gangrenous digits of the lower extremity. In this case, a 62-year-old Caucasian male with past medical history of diabetes mellitus with peripheral neuropathy, hyperlipidemia, hypertension, coronary artery disease and partial fifth ray resection left foot presented to Aventura Hospital and Medical Center Emergency Department complaining of worsening malodor and gangrenous change to the dorsal aspects of digits 1 through 4 of the left foot after failed outpatient treatment. After the initial consultation, patient underwent repair of critical tibioperoneal trunk stenosis with balloon angioplasty by interventional radiology. Three days later, the patient elected to undergo surgical sharp excisional debridement of non-viable soft tissue and bone of digits 1-4 of the left foot with application of acellular dermal matrix. Six months post operatively, there was noted complete healing of the tissues without any complications. In conclusion, acellular dermal matrix can be a useful biologic for tissue regeneration of digital ulcerations and/or gangrene as an alternative to digital amputation.