“…1,2 Primary venous aneurysms, referring to those without clear etiologies of trauma, surgery, arteriovenous fistulas, or congenital vascular disease, have been reported in the extremities, neck, and occasionally in the iliofemoral axis. 3,4 Retroperitoneal venous aneurysms, which may originate from the inferior vena cava, iliac vein, or renal veins, are extremely rare, and diagnosis in such cases can be challenging because they often mimic soft tissue tumors. 5,6 Here, we present this rare case of a large pelvic venous aneurysm originating from the presacral venous plexus, which, to the best of our knowledge, has not been reported previously to be involved in venous aneurysm formation.…”