We present a case of a 35-year-old male patient who underwent live donor kidney transplantation at our unit in 2003. While working overseas, he had deterioration in his kidney function and was treated conservatively over three years duration including acquirement of a renal biopsy. Upon presentation to our unit in June 2015, an ultrasound and computed tomography angiogram demonstrated a huge aneurysm arising from his upper renal artery. His lower renal artery was patent and normal. The aneurysm was treated by endovascular means with preservation of the kidney and improvement in his kidney function over the following 12 months. When feasible, endovascular repair of transplanted renal artery aneurysms provides a safe and less invasive modality of treatment.