A giant femoral anastomotic aneurysm occurred following a repeat femoro-popliteal bypass reconstruction for exclusion of a recurrent popliteal aneurysm. The first bypass was with an autologous vein, and the second bypass was performed with a below-knee PTFE graft. A giant femoral anastomotic aneurysm was repaired 8 years and 6 months later with interposition of an 8 mm Dacron graft from the junction of the external iliac and femoral artery junction to the profunda femoris artery, with known occlusion of the left superficial femoral artery (SFA) and popliteal artery. At a follow-up of 6 months, the patient is doing well with symptoms of mild ischemic rest pain.