Congenital arteriovenous malformations in the upper extremity, mainly in the hand are rare. In this patient an arteriovenous fistula of the hand caused arterial dilatation of the upper limb, and blunt injury of brachial artery resulted in an extreme large false aneurysm. This situation, which threatened with rupture and peripheral embolisation was treated by resection of the false aneurysm with end-to-end direct anastomosis. Complication of a congenital arteriovenous malformation so late, in the ninth decade is almost exceptional. We think that the successful surgical treatment of an infrequent lesion's rare late complication is worth presenting.