This is a case of a patient that presented to the outpatient department with a large chronic iliac artery aneurysm and the anesthetic complications that occurred during the surgical resection of the swelling and associated management of massive blood loss, and hemodynamic changes that occurred during the cross clamping and unclamping of the aorta. In this case report we discuss the importance of being prepared for the expected and unexpected complications, accepted ischemia time, need for inotropic supports, and then the management of associated hypotension during the unclamping of the aorta, and most importantly, a vigilant anesthetist! BACKGROUND Chronic Iliac artery aneurysms are a rare finding in the medical world. Surgical removal of the aneurysm is the only feasible solution for the condition, otherwise risking sudden rupture and catastrophic consequences. The dire size of the aneurysm and chronicity of this particular case, required for a well prepared, planned anesthetic management, expecting multiple complications. This article is an attempt to help our fellow doctors, to deal with similar scenarios.