A case of a nonanastomotic, atheromatous aneurysm in a femoropopliteal saphenous vein graft is presented. This disease is unusual, especially in nonsmokers with normal lipid levels, and, in this case, may be related to mechanical graft failure 22 years after implantation. The aneurysm was excised and the arterial continuity reestablished with a prosthetic graft.