The incidence of pseudoaneurysm after total hip arthroplasty is extremely rare. The most common mechanism of vascular injury is due to direct trauma during the operative procedure and most reported cases are acute in a presentation. We report an unusual case of pseudoaneurysm of the external iliac artery, presenting 6 years after initial surgery, and occurring following septic loosening of total hip arthroplasty. This case highlights the importance of prompt recognition of infection of total hip arthroplasty, and also indicates the need for prompt and appropriate treatment for these infections.