Our aim is to present a case of a common iliac artery pseudoaneurysm, which complicated an allograft nephrectomy. A 27-year-old woman presented with acute abdominal pain and a palpable pulsatile mass in the right iliac fossa, 1 year after a right pelvic allograft nephrectomy. An iliac pseudoaneurysm was suspected and confirmed on triplex ultrasound and CT angiography. The patient underwent a pseudoaneurysm resection with direct repair of the previous allograft Carrell patch suture dehiscence. The intervention and recovery were uneventful and after a follow-up of 6 months, the patient remains asymptomatic with no clinical or imaging recurrence of the pseudoaneurysm.Vascular complications following allograft nephrectomy are rare but may present significant morbidity and mortality. Endovascular exclusion is currently the preferred option for the management of pseudoaneurysms following allograft nephrectomy; however, open surgical approach remains an alternative for selected patients.