Persistent sciatic artery (PSA), a persistent embryologic continuation of the internal iliac artery, represents a rare yet clinically important vascular anomaly. PSA is prone to aneurysmal change, which can subsequently lead to distal embolization, sciatic neuropathy, or rupture. The conventional surgical treatment of PSA aneurysms is commonly complex and carries the risk for sciatic nerve damage. We report herein the successful endovascular management of a PSA aneurysm and postaneurysmal stenosis with the use of two overlapping self-expanding stent-grafts via a contralateral transfemoral approach. Additionally, a review of the literature regarding the treatment of these unusual peripheral aneurysms is provided.