Highlights Axillary artery aneurysms are an uncommon upper extremity pathology and Arteriovenous malformations (AVMs) are a rare cause. We present a case of congenital high-flow AVMs in the upper limb who presented with an asymptomatic axillary artery aneurysm. Our patient was asymptomatic, but surgery was indicated because of the size of the aneurysm. We used a vein graft instead of a synthetic graft because the aneurysm was located close to the shoulder joint.