Objective <p>Vascular embolism constitutes a severe complication of fat grafting, particularly in the temporal region—a common injection site predisposed to embolic events. Despite its clinical significance, successful management strategies remain insufficiently documented. We present a successfully managed case of multifocal arterial embolism following temporal fat grafting, providing critical insights into therapeutic strategies.</p> Methods <p>A systematic analysis of a temporal fat embolism case was performed, combined with a comprehensive literature review of vascular complications in facial fat grafting.</p> Results <p>A patient developed acute multifocal cerebral infarctions and right external carotid artery stenosis 17&#xa0;h post-temporal fat grafting. Comprehensive treatment including volume expansion, anticoagulation, circulation enhancement, infection control, neuroprotection, rehabilitation, and supportive care resulted in clinical recovery and successful discharge.</p> Conclusion <p>Active intervention for multifocal arterial embolism following temporal fat grafting can yield favorable outcomes even beyond the optimal thrombectomy window, with multidisciplinary collaboration being paramount for effective management.</p> Level of Evidence IV <p>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors <a href="http://www.springer.com/00266">www.springer.com/00266</a>.</p>