A contained rupture of a femoral anastomotic aneurysm presented as a pulsatile tender mass with ecchymosis in the groin 56 months after aortobifemoral grafting for iliac artery occlusion. CT scan of abdomen and pelvis revealed a leaking right femoral anastomotic aneurysm. Repair was performed by resection of the femoral anastomotic aneurysm with an interposition of an 8 mm Dacron graft from the femoral graft limb to the profunda femoris artery, with satisfactory outcome. The patient had a known right superficial femoral artery occlusion. There has not been any recurrence of the anastomotic aneurysm or lower ischemic symptoms at 6 years of follow-up.