Fewer than 100 internal iliac artery aneurysms have been reported in t
he English literature. Of these the incidence of true aneurysms occurr
ing after aortic reconstruction is exceedingly low. A 73-year-old man
presented with a 7 cm asymptomatic left internal iliac artery aneurysm
12 years after repair of an abdominal aortic aneurysm with a bifurcat
ion graft. We report our experience with this patient along with a rev
iew of the literature and recommendations fdr aneurysm surveillance.