A 75-year-old male with a history of allergy to iodinated contrast media was referred for the treatment of the left subclavian artery aneurysm. The aneurysm was saccular and maximum diameter over 30 mm. Stent grafting was performed with the use of gadolinium-based contrast agent and intravascular ultrasound (IVUS). Ipsilateral vertebral artery was temporarily occluded with a balloon catheter to protect against distal embolism. The IVUS reduced the amount of gadolinium-based contrast agent. There were no neurological, renal or other complications after the treatment. Stent grafting of the left subclavian artery aneurysm may be safely performed with gadolinium-based contrast agent and IVUS, even if iodinated contrast media is contraindicated.