Sometimes a routine surveillance graft scan discloses something not so routine: in this case, giant pseudoaneurysms in the midsection of a lower-extremity bypass graft. This case report details a complication of cryopreserved vein grafts, underscoring the importance of routine surveillance imaging. It also illustrates adverse patient consequences that occur from a misdiagnosis with ultrasonography and demonstrates the critical role of the vascular sonographer in an integrated patient care team.