Iliac artery aneurysms are most commonly associated with aortic aneurysms.
Isolated iliac aneurysms are less common but are frequently bilateral at ti
me of presentation. The incidence of metachronous iliac aneurysm formation
is unknown. The authors present a case report of a patient with metachronou
s rupture of iliac aneurysms occurring 3 years apart. The presence of a uni
lateral iliac aneurysm should prompt close surveillance with computed tomog
raphy to identify metachronous lesions before they become symptomatic or ru
pture in order to decrease the morbidity and mortality associated with rupt
ured iliac aneurysms.