The renal artery aneurysms (RAAs) represent 3% of all visceral aneurysms. Their incidence rate is about 0.1% in the general population [1], even if angiographic findings report a little higher incidence (0.3-2.5%) [2] with a modest prevalence in female patients. RAAS are mainly detected in the sixthseventh decade, and female patients are associated with an earlier incidence [3]. True RAAs are extra-parenchymal in 90% of cases, while intraparenchymal RAAs represent 10% of cases, and they are often multiple and congenital. RAAs can be saccular in 75% of cases or fusiform. Saccular RAAs usually affect the main renal artery bifurcation, while fusiform aneurysms often involve the main arterial trunk [4]. RAAs can be bilateral (10-20%) or associated with a multiple location. High calcifications are detected in 18-68% of cases [1]. HRAAs represent a rare subgroup of RAAs, located in the distal part of the renal artery, very close to the renal hilum even though they are considered extra-parenchymal (Fig. 12.1). In addition to "true aneurysms," the main renal arteries and their collaterals can be affected by: