Superior mesenteric artery (SMA) aneurysm is rare but shows high risk of rupture. Mycotic aneurysm is the most common cause of SMA aneurysm, followed by atherosclerosis. Diagnosis is usually made by ultrasonography or abdominal CT scanning. Because of its particular anatomy, surgical treatment is often challenging for the surgeons. We present a successful reconstruction of the SMA after ligation of SMA aneurysm in a 43-year-old man who suffering from epigastric and back pain for 5 months.