We report a case of a 78-year old male patient with a history of hematuria. Diagnosis of a shunt between a left common iliac artery aneurysm and the ipsilateral ureter was arrived at on the basis of arteriographic findings. Surgery consisted in ligating the left ureter proximal and distal to its communication with the aneurysm (left kidney silent on intravenous urogram), in closing the arterial orifices proximal and distal to the aneurysm, and in constructing an extraanatomical interfemoral bypass. At sixteen months' hindsight, the patient is doing well. Literature is reviewed (24 entries).