Backround: Intercostal artery pseudo aneurysm (ICPA) is a rare disease entity, with only a few cases reported so far in English literature. They form as a result penetrating thoracic trauma, infection or iatrogenic injury. ICPA can be asymptomatic or can present with massive hemothorax. Case report: An elderly man presented with hemothorax following stab injury, he was managed with intercostal tube drainage (ICTD) and discharged in satisfactory condition, only to return with recurrent hemorrhage from ICTD site two weeks after discharge. We excised the aneurysm and removed the clots from thoracic cavity via posteriolateral thoracototmy. Conclusion: Due to their rarity ICPA can be misdiagnosed and patient might present late. Our case highlights the importance of keeping high index of suspicion in patients of stab injury to chest presenting with recurrent hemothorax.