Acute thrombosis of the popliteal aneurysm may present symptoms of intermittent claudication or limb-threatening ischemia. Following clinical evaluation and duplex arterial study, CTA of the aorta and arteries of the lower extremity should be obtained. In patients with limb-threatening ischemia, urgent arteriography using contralateral femoral artery access is obtained, and in patients with occlusion of the infrapopliteal arteries, intra-arterial thrombolysis is started. Exclusion, and in some cases, partial excision, of the wall of the popliteal artery aneurysm with interposition of an autologous vein or a prosthetic graft is performed. The reported mortality rate of 3.2% in patients presenting acute ischemia due to thrombosed popliteal aneurysm has been reported.