Background: The dissection of the iliac artery aneurysm is considerably rare, with limited documentation in the existing literature. Iliac artery dissection can be attributed to several causative factors, including trauma, pregnancy, athletic activity, arterial catheterization, and connective tissue disorders.

Methods: This case reports a 72-year-old male complaining of pain in the right iliac fossa and hypogastric region, radiating to the back. An abdominal ultrasound revealed a right dissected common iliac aneurysm, left common iliac aneurysm and an abdominal aortic aneurysm. Further investigation confirmed the same findings. Several hours later, the decision of emergency surgery was done due to signs of hemorrhagic shock caused by ruptured unilateral iliac aneurysm. The aneurysms were successfully repaired by aorto-bi-iliac dacron-graft bypass and palpable femoral pulses noted at the end of the surgery.

Conclusions: Close monitoring of these patients is crucial due to the significant morbidity associated. Early intervention may be necessary, particularly before any signs of deterioration and hemorrhagic shock.