spontaneous pseudoaneurysm of the femoral artery is extremely a rare entity.(1 ) it can be secondary to the rupture of a true aneurysm , but in most events the cause is unclear.(2 ) most patients with non - atherosclerotic pseudoaneurysms of sfa are asymptomatic initially and later present with a pulsatile , expanding mass along the anatomical course of sfa in the thigh and have a history of some trauma or surgical procedure.(3 ) due to their complications , large pseudoaneurysms require some kind of intervention . if not treated , they are at risk for rupture , infection , distal embolization or arteriovenous fistula formation . ( 1 ) we report a young patient with spontaneous femoral artery pseudoaneurysm without any history of trauma or vascular intervention successfully treated surgically . a 29-year - old healthy man presented with right thigh swelling since 2 months which is painful throbbing in nature and aggravated by walking . there was no history of local trauma and he had never suffered peripheral vascular disease . on presentation , he was hemodynamically stable and there was a tender swelling at the medial aspect of right mid thigh which was pulsatile . ct angiogram was done which showed a pseudoaneurysm of the lower third of femoral artery . ct angiogram showed a pseudoaneurysm of the lower third of femoral artery a surgical excision of the pseudo - aneurysm was done under general anesthesia . after evacuation of hematoma , there was a large defect in the wall of the artery . therefore , a greater saphenous vein interposition graft was used to maintain the vascular continuity . formation of a femoral artery pseudoaneurysm is not infrequent after femoral arterial access , and it occurs in up to 0.7% of the diagnostic procedures and in up to 8% of the interventional procedures . ( 4 ) recently , there has been a significant decrease in both major and minor vascular complications after diagnostic and therapeutic procedures with an incidence of pseudoaneurysm less than 0.3 % . ( 5 ) spontaneous pseudoaneurysm of the superficial femoral artery in the young age group is a rare occurrence . some of the false aneurysm may close spontaneously but rupture is a major concern followed by thrombosis , distal embolization and compression of adjacent structures . ( 3 ) atherosclerosis has been proposed by several authors as an etiologic factor in spontaneous perforation of the femoral arteries or its branches . ( 6 - 8 ) in these case reports , the patients were elderly with atherosclerotic changes in their peripheral arteries and weakening of the arterial walls could have led to spontaneous rupture . patients who have inherited connective tissue disorders such as ehlers - danlos have also been reported to present with spontaneous rupture of their arteries because of the fragility of their arterial walls . ( 9 ) . our patient , however , was young and there was no evidence of atherosclerotic changes in his arteries on the angiogram or during surgery . furthermore , he did not have any clinical features to suggest an inherited connective tissue disorder . there was also no history for any trauma and for which we labeled him to have a spontaneous femoral artery pseudoaneurysm . therapeutic options for femoral pseudoaneurysm include open surgical repair , ultrasound - guided compression , ultrasound - guided thrombin injection , coil embolization , and endovascular repair using stent - grafts . ( 10 ) particularly in young patients , an appropriate approach is surgical exploration with hematoma evacuation and arterial repair by means of arterial suture , patch angioplasty , or graft interposition . ( 2 ) femoral artery pseudoaneurysm has been a common complication after the wide use of femoral artery access for diagnostic and therapeutic procedures . however , spontaneous rupture of the artery without trauma remains a rare entity . as there are many evolving types of management , the surgical intervention may has superiority when there is a suspicious of underlying vascular pathology .