Introduction: Pseudo aneurysms occur due to injury to arterial wall. Due to sustained arterial pressure, blood dissects into the tissues around the damaged artery and forms a perfused sac that communicates with the arterial lumen. The perfused sac contains media or adventitia or simply soft tissue structures surrounding the injured vessel.

Material and Methods: We analysed 32 patients who underwent surgical AVF takedown after formation of pseudo aneurysm at our centre over a period of 3 years between September 2018 to September 2021.

Results: 32 patients (26 males and 6 females) underwent takedown of AVF during this 3 years period. 22 (84.62%) had fistula on their left arm as compared to 4 (15.38%) having fistula on their right arm. 21 (80.76%) were brachiocephalic fistulas while the remaining 5 (19.24%) were radio cephalic. 25 (78.12%) presented as pseudo aneurysms with a risk of impending rupture, while 7 (21.88%) presented with aneurysmal rupture. 14 (43.75%) underwent the procedure under axillary block, 18 (56.25%) were operated under local anaesthesia and minimal sedation. Mean operative time was 75.72 ± 24.27 min. 26 (81.25%) underwent excision of aneurysm with ligation of proximal and distal end of arteries while 6 (18.75%) underwent arterial reconstruction with venous interposition grafting. Mean duration of hospital stay was 3.4 days with a maximum of 7.2 days. 6 of our patients had post op wound infection. All patients had good distal pulsations in the postoperative period.

Conclusion: Pseudo aneurysms pose threat to both limb and life. Planning is necessary for properly managing these patients. Though surgical excision of aneurysm with reconstruction