True aneurysm of the facial artery is extremely rare. We describe a case of true facial aneurysm of the submandibular lesion in a 73-years-old man. A color Doppler ultrasonography and computed tomography (CT) revealed a 2.1 cm x 1.5 cm aneurysm with turbulent arterial flow and some thrombus inside the lumen. At the operation, the aneurysm was excised and proximal and distal ends of the facial artery were ligated. The histopathologic examination confirmed a true aneurysm of the facial artery with degenerative changes of the wall and some thrombus in the lumen. The postoperative course was uneventful, and no recurrence has been noted in more than 1-year follow-up.
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