The authors report the case of a 72-year-old man with new but vague epigastric pain. CT scan and selective coeliac trunk angiography demonstrated a common hepatic artery aneurysm (HAA). He was treated surgically by ligation and excision without revascularization. Asymptomatic hepatic aneurysm should be treated aggressively because the natural course seems to be progression to rupture associated with a high mortality rate. The authors discuss the clinical scenario of patients with HAA and stress the importance of the early treatment. In addition the therapeutic options are explored.