We report the case of a 65-year-old man who presented with an infrarenal aortic aneurysm in association with a congenital right pelvic kidney vascularized by 2 aortic arteries, 1 of which arose from the aneurysmal aorta and the other from the common right iliac artery. Successful surgery consisted of excising the aneurysmal aortic segment and replacing it with a Dacron tube graft, then implanting the upper renal artery (supplemented by a short segment of saphenous venous graft) in the Dacron prosthesis. We review 6 other cases of this rare pathologic association, found in our search of the literature, and discuss techniques of renal protection and (when necessary) reimplantation of the anomalous arteries.