Background: Anastomotic pseudoaneurysm is an underestimated complication of aorto-iliac grafts.
Case report: This case report describes an unusual presentation of a pseudoaneurysm with a particularly complex anatomy involving both the left iliac branches, which hindered the interpretation of diagnostic studies and therapeutic management in a patient with multiple comorbidities.
Conclusions: The manuscript describes a successful management of such a complication by means of an elective endovascular approach.
Keywords: Aneurysm, False; Aortic Aneurysm, Abdominal; Endovascular Procedures.