A case with a saccular iliac venous aneurysm, about 25 cm in diameter, due to a femoral arteriovenous (AV) fistula caused by a stabbing and penetrating injury with forty-one years' duration and an accompanying aneurysmal left iliac artery is reported. The iliac venous aneurysm was pulsatile and diminished by external compression. The diagnosis was made by physical examination and confirmed with angiography, ultrasonography, and computed tomographic scanning. The AV fistula communication was closed, the left iliac aneurysm was repaired, the giant venous aneurysm was resected, and the iliac vein was anastomosed end to end. The follow-up period was nine months. Literature concerning this subject was reviewed.
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