The presence of a persistent sciatic artery is a rare congenital vascular malformation. Complications associated with aneurysmal degeneration of this aberrant vessel include rupture, thrombosis, and embolization with obliteration of outflow vessels. We describe the case of an 82-year-old female presenting with critical limb ischemia due to embolization from a partially thrombosed persistent sciatic artery aneurysm. Successful treatment was achieved via a common femoral to posterior tibial artery bypass with the great saphenous vein and vascular plug embolization of the aneurysm.