Vascular injury is a rare complication following total hip arthroplasty. Most reported cases of vascular trauma around the hip concern fracture and its surgical correction. Pseudoaneurysm formation often presents late. Persistent hip pain, thigh swelling and anaemia should raise suspicion. We present a case of a pseudoaneurysm of the medial circumflex femoral artery that presented following a left total hip arthroplasty using a cemented Charnley Elite system via an antero-medial approach.