ALTHOUGH aneurysms of the abdominal aorta and iliac arteries have received much attention in recent years, very little has been written about hypogastric artery aneurysms. A recent experience with a patient who had rectal, urethral, and ureteral obstruction from a large hypogastric artery aneurysm prompted this review. A review of 671 hospital records containing the diagnosis of aortic or iliac artery aneurysm, or both, disclosed only three cases of isolated hypogastric artery aneurysms. One of these patients has been studied and treated by the authors. His case will be presented in detail, and the other two cases will be briefly presented. Report of Cases Case 1. —An 86-year-old white man had a six-month history of increasing difficulty with urination and bowel movements. He had noted frequency, hesitancy, intermittency, dribbling, strangury, and nocturia two to three times. He had also noted abdominal fullness, flatulence, increasing difficulty with bowel movements, and intermittent