We present a case of endovascular repair of a giant iliac artery pseudoaneurysm following simultaneous pancreas-kidney transplantation. A 64-year-old female presented to the emergency room with right flank pain 10 months after kidney and pancreas transplantation on the right iliac axis. Investigations revealed a 9.5 cm pseudoaneurysm originating from the anastomosis between the graft renal artery and the external iliac artery. The pseudoaneurysm was successfully excluded emergently with a covered stent graft preserving the normal perfusion and function of both transplanted organs. Endovascular repair may be a good and low-invasive option in selected patients with transplant renal artery pseudoaneurysm.