The authors present a seventy-eight year old woman with an aneurysm of the main pulmonary artery. Although a surgical approach is generally considered life-saving by preventing rupture of the aneurysm, literature is unclear about possible rupture in the specific situation of a pulmonary artery aneurysm without a causative cardiac lesion and/or pulmonary hypertension. In fact, some reports suggest a conservative treatment for this specific entity. Therefore we did not operate on our patient and she remains stable at 18 months follow-up.