Increasing utilization of diagnostic imaging studies has provided newer insight into our current knowledge of visceral artery aneurysms. Because many are "silent," an appreciation of the true incidence and natural history of these nonaortic arterial aneurysms is only recently being understood. Historical data suggest that renal artery aneurysms (RAAs) occur in approximately 0.1% of the general population. Recognized complications associated with RAAs include renovascular hypertension, renal artery thrombosis, infarction from distal embolization, arteriovenous fistula formation, and, the most dreaded risk, rupture. Unfortunately, there remains continued controversy about the indications for and mode of treating RAAs. This article attempts to shed some light on the contemporary management options in view of advances in percutaneous endoluminal interventions.