Adventitial cystic disease of the popliteal artery is a rare condition of debated aetiology. The recommended treatment has been cyst removal with or without replacement of the artery. Recently percutaneous aspiration has been suggested as another method of treatment for this condition. In this case, percutaneous aspiration was performed twice. Surgical intervention was eventually performed because of early cyst recurrence. Our experience suggests that aspiration is a treatment option but, if used, close long-term follow-up is necessary to detect recurrence.