The authors consider isolated iliac artery aneurysms. While the incidence of isolated iliac lesion is, as literature reports, quite low, it rises up to 20% when associated with aortic lesions. The clinical findings are often characterized by effects of compression on the intrapelvic structures, by neurological symptoms and decreased venous flow. Diagnosis is based on ecography, CT and angiography for the definition of side and extension of the aneurysmatic lesion. From the technical point of view, the surgical approach is based on the dimensions of aneurysm and its mono- or bilateral extension. The most common approach in case of bilateral aneurysms or aorto-iliac lesions is transperitoneal, while it's limited to extraperitoneal way, when isolated iliac lesion. If the aneurysm involves the hypogastric artery, mostly when bilateral, the risk of bowel ischemic complications becomes more significative.