Over a 21 month period, 112 patients were seen in the vascular laboratory for evaluation and therapy of possible pseudoaneurysm. Pseudoaneurysm was confirmed by color flow sonographic imaging in 31 patients. Twenty‐eight of these patients underwent sonographically monitored extrinsic manual compression to induce thrombosis and subsequent obliteration. Complete manual thrombosis was achieved in 17 patients while partial thrombosis with subsequent spontaneous closure developed in three patients, for a total success rate of 71% (20/28). In eight patients attempts to thrombose the pseudoaneurysm failed (29%). Induction of thrombosis by manual compression was successful in the presence of oral and intravenous anticoagulants. No therapeutic complications were encountered. Under proper sonographic guidance, the technique of manual obliteration of pseudoaneurysms provides a safe and effective alternative to surgical intervention.