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Background and Aims Thromboangiitis obliterans (Buerger’s disease) is a non-atherosclerotic, segmental inflammatory occlusive vasculitis which impacts small and medium-sized arteries and veins in the extremities. Ischemic pain in these individuals can be challenging to manage, particularly when revascularization is not a feasible option. This case series highlights the use of continuous sciatic nerve block as an alternate analgesic treatment.Methods We report two cases of patients with Buerger’s disease who received continuous sciatic nerve blocks for pain management. Case 1: A 42-year-old male with critical limb ischemia with cyanosis of the right foot’s first two toes complained of extreme pain (NRS 9/10). A distal sciatic nerve block with 20 ml of 0.375% Ropivacaine had been carried out, followed by catheter implantation for continuous infusion of 5 ml/h 0.2% leading to a result of NRS 3/10. The presence of the block allowed in a later fashion a successful transmetatarsal amputation and subsequent discharge with proper analgesic medication Case 2: A 73-year-old female presented with severe right lower limb ischemic pain (NRS 10/10) with a history of endovascular treatment for femoral artery occlusion two months ago. Following a diagnosis of thromboangiitis obliterans, a distal sciatic nerve block with the same bolus dose and the catheterization protocol was implemented with pain reduction NRS 4/10. Despite multiple catheter replacements during a prolonged hospitalization, the patient eventually required an above-knee amputation due to progression to gangrene.Results Both patients reported significant pain alleviation after sciatic nerve block NRS 9–10/10 to NRS 3–4/10. In the first case, the intervention aided a limb salvage surgical procedure.Conclusions Continuous peripheral nerve blockade may be a useful pain management option for individuals with Buerger’s disease, especially when other pharmacological or surgical interventions are restricted. Further research on its long-term effectiveness and incorporation into therapy methods should be conducted.