Purpose: Isolated external iliac artery aneurysms are rare and may present with compressive symptoms, incidental imaging findings, or rupture. We present a case of isolated external iliac artery aneurysm managed with open repair. Methodology: A 65 year old male patient underwent evaluation for an external iliac artery aneurysm identified on cross-sectional imaging. Pre-operative assessment confirmed isolated iliac disease without significant associated aortic pathology. Given the aneurysm anatomy and the planned operative strategy, open surgical repair was undertaken. Results: After consideration of open and endovascular options, the aneurysm was successfully managed with open reconstruction. The procedure successfully resected the aneurysm with restoration of arterial continuity. Histopathology confirmed a degenerative atherosclerotic aneurysm. The post-operative course was uncomplicated, and follow-up demonstrated a satisfactory outcome. Conclusion: Isolated external iliac artery aneurysm is an uncommon vascular pathology. Although endovascular options are increasingly used, open repair remains an important treatment strategy in selected patients based on anatomy, symptoms, and operative considerations. This case highlights the importance of individualised planning in iliac aneurysm repair.