The authors report a case of popliteal vein aneurysm (PVA) in a healthy patient who presented with symptoms and review the literature. A 40-year-old healthy male presented with hypoxia secondary to pulmonary emboli. He underwent diagnostic tests revealing a suprageniculate saccular PVA, which was treated by aneurysmectomy and lateral venorrhaphy. A follow-up duplex scan after 18 months showed patent popliteal vein in an asymptomatic patient. A review of 120 cases identified revealed that the most common presentation of PVA is because of thromboembolic complications, often having saccular morphology. Patients were at risk of thromboembolic complications whether intraluminal thrombi were present (63% of the cases) or not. Patients treated with anticoagulation alone had a failure rate of 43%, with thromboembolic complications. Surgical repair of PVA--regardless of the aneurysm size--should be considered in all patients to decrease the risk of thromboembolization.