A patient with a large congenital pelvic arteriovenous malformation pr
esenting with irradiating pain to the leg, most likely due to sciatic
nerve compression, is described. Congenital pelvic arteriovenous malfo
rmation are rare lesions, especially in males. Diagnosis was establish
ed by arteriography and contrast-enhanced computed tomography scan. Su
rgical resection of the AVM relieved our patient of all symptoms. Howe
ver, endovascular therapy, either as primary treatment or followed by
conventional surgery is the treatment of choice. Pelvic arteriovenous
malformations should be considered in the differential diagnosis of un
explained sciatica.