Coronary pseudoaneurysm is a complication of angioplasty occurring in 4-5% of cases. The likely etiology of the pseudoaneurysm is an iatrogenic dissection. Although increasingly identified, they are infrequently reported and no large series has been documented. The case of a 64-year-old patient with a post-PTCA coronary pseudoaneurysm that was treated surgically is presented. A review of the world's literature identifies stenosis as a major cofactor in operative intervention and raises the possibility that aneurysm formation promotes stenosis.