Brachial arterial pseudoaneurysms are rare arterial disorders. Usually, they are always related to myriad underlying pathologies ranging from atherosclerosis, and connective tissue disorders to traumatic injuries as trivial as iatrogenic arterial puncture during phlebotomy. We report a case of a 35-year-old female who presented with ecchymosis all over the distal half of the right arm and proximal forearm with pain and tenderness. She was taking an oral anticoagulant (acenocoumarol 2 mg daily) for thromboprophylaxis of the prosthetic mechanical mitral valve. On baseline investigations, her prothrombin time was more than 90 seconds and her INR was more than 7. On USG, muscular hematoma along with a small pseudoaneurysm measuring 20 mm x 16 mm was detected at midarm. She denied any trauma in past. She was conservatively managed with vitamin K, transfusion of fresh frozen plasma, analgesics, and topical medications. She was discharged from ED after 48 hours of observation.

Keywords: Pseudoaneurysm; Brachial Artery; Coagulopathy