Background: True popliteal aneurysm complicated with distal arterial embolization and popliteal vein thrombosis is rare. Case Report: We report a case of a 26-year-old male with popliteal artery aneurysm who presented with two major complication related to the aneurysm; distal arterial embolization and popliteal vein thrombosis. He was treated successfully by vein graft interposition and anticoagulation therapy. Conclusions: This case suggests popliteal aneurysm may cause concurrent limb-threatening complications such as acute leg ischemia and deep venous thrombosis.