True isolated "arteriosclerotic" aneurysms of the superficial femoral artery are rare. One case of isolated superficial femoral artery aneurysm and review of literature is reported.Case report and review of the literature.Hospitalized care.An 80-year old man presenting with rupture of superficial femoral artery aneurysm was observed and treated with graft interposition, which resulted in limb salvage.Removal of the aneurysm and replacing of the arterial aneurysmatic segment by interposition of a polytetrafluoroethylene prosthetic graft.Patency of the graft with no evidence of ischemic or embolic complication assessed with a follow-up period of 6 months.From the review of the literature we collected 21 isolated true arteriosclerotic superficial femoral artery aneurysms in 17 patients. These aneurysms may be discovered after the onset of complications such as rupture (33%) or thrombosis and limb ischemia (19%). Other aneurysms are frequently concomitant (69%), mostly represented by abdominal aortic aneurysms (40%).Ruptured arteriosclerotic aneurysm of the superficial femoral artery is very uncommon and the treatment of choice is based on replacing of the aneurysmal segment with a prosthetic graft interposition or proximal and distal artery ligation and bypass. Early diagnosis and surgical reconstruction is recommended for patients with aneurysms of the superficial femoral artery that are 2.5 cm or greater in maximum diameter and for complicated aneurysms of any size.