Persistent sciatic arteries are a rare developmental anomaly prone to aneurysm formation and atherosclerotic disease. We present a case of a patient with bilateral persistent sciatic arteries presenting with unilateral claudication due to a symptomatic stenosis. The stenosis (just above knee) was treated with angioplasty via popliteal puncture. The puncture was complicated by pseudoaneurysm formation. Persistent sciatic arteries can cause diagnostic difficulties as Duplex ultrasound can give the impression of an occluded superficial femoral artery. Angiographic techniques are the mainstay of diagnosis and we demonstrate both conventional and CT angiographic appearances.