SA aneurysm (SAA) accounts for up to 50% to 75% of all visceral artery aneurysms associated with a high mortality rate of 25% in case of aneurysm rupture. It is the third most common intra-abdominal aneurysm following those of the aorta and the iliac arteries. The incidence of SAA varies from 0.1 to 10.4% in the general population. It has anatomic variations in about 10% of the population, 1% of which emerging from the superior mesenteric artery. Accordingly, SAA arising from a spleno-mesenteric trunk is very rare. To our best knowledge, there are only a few cases reported in the literature up to date. This is a review of literature and reported cases with anomalous SAAs arising from a spleno-mesenteric trunk, which had been diagnosed by ultrasound (US), computed tomography angiography (CTA), digital subtraction angiography (DSA), and managed by open surgery.