The purpose of this article was to obtain a more clear view in the management of popliteal artery aneurysms (PAAs). When do we need to treat it and how is it best treated? After going through multiple review articles and case reports concerning this matter, we came to the following conclusions. Repair of a PAA is indicated when it reaches a postero-anterior diameter of 3 cm (at higher risk for thrombosis) or becomes symptomatic (mild claudication or severe ischemic symptoms). Whether the repair is then performed in an endovascular (Endovascular repair) or open way (Open repair), depends on the personal experience and clinical evaluation of the surgeon.