A 41-year-old man admitted to our hospital because of diffuse abdominal pain lasting five days was referred to our department due to rupture of an abdominal aortic aneurysm during surgery. Chest radiographic finding were normal, but abdominal CT showed an irregular low-attenuation mass, about 3x4x5 cm in size and with rim enhancement, in the left para-aortic region anterior to the left psoas muscle, as well as a small aortic aneurysm (Fig. 2A). At that time, the radiological diagnosis indicated a psoas abscess. After surgical drainage of this and biopsy of the lesion, rupture of the aortic aneurysm and massive bleeding developed, and we therefore promptly deployed an endovascular stent graft 5 cm in length and 15 mm in diameter (Vanguard Straight; Boston Scientific) through the right femoral artery. Angiography revealed a 6x12 mm-sized aortic aneurysm at the level of the inferior mesenteric artery, and this was successfully occluded with the stent graft. The biopsy specimen consisted mainly of clots, and the polymerase chain reaction technique showed that this was positive for tuberculosis. After placement of the stent graft, anti-tuberculous medicine (isoniazid, rifampin, and etambutol) was administered, and follow-up CT three months later showed that the aneurysm had completely disappeared and the psoas abscess completely healed (Fig. 2B). Eighteen months after the procedure, neither complications related to stent-graft deployment nor a recurrent psoas abscess had been encountered.