Popliteal artery aneurysm rupture represents a diagnostic and therapeutic challenge. In this case report, we report the open surgical therapy of an enormous ruptured popliteal artery aneurysm (rPAA) (13 cm), emphasizing key points in diagnosis and treatment decision-making. The symptomatology of rPAAs is often misleading, with nonspecific signs such as edema and pain, which can lead to delayed diagnosis. Early recognition and appropriate treatment are critical to avoid complications such as acute limb ischemia and amputation.