Internal iliac artery aneurysms are rarely discovered by examination and may consequently present with rupture in a patient without an established diagnosis. Ruptured internal iliac aneurysms harbor a high risk of morbidity and mortality. Although open repair is possible, endovascular repair may be an option in some patients. We present a case of a ruptured internal iliac artery aneurysm with an adjoining ipsilateral common iliac artery aneurysm repaired with a novel use of an aorto-uni-iliac device.