A case of aortocaval fistula complicating a ruptured infrarenal aortic aneurysm is reported. As the length of the defect and the thickness of the aortic wall made repair from within the aorta unsafe, the defect was repaired from within the vena cava. The details of the technique are reported. It can be a useful alternative to inferior vena cava ligation, when standard repair of aortocaval fistulae from within the aorta is risky or difficult to attempt.