Hepatic artery aneurysms (HAAs) are considered rare even though their reports in the literature are becoming more and more frequent. The great improvement in the diagnosis of vascular diseases and the increasing incidence of atherosclerosis have resulted in a wider recognition of these pathologies. Differently from other splanchnic locations HAAs have a high risk of rupture (up to 80%) so that an aggressive treatment is required. Different therapeutic options are currently available: simple ligation of the artery, aneurysm excision and vascular reconstruction, transcatheter embolization. However, the therapeutic choice must be evaluated in each single case, depending on the size, aspect and locations of the aneurysm, and requiring an accurate study of the collateral vascular supply. Finally, since additional aneurysms in other sites are frequent, a dose follow up of these patients is recommended.