This is to report a case of huge Abdominal Aortic Aneurysm presenting as constipation in an elderly Nigerian male. This is a rare disease in Nigeria and it is hoped that the report will further arm clinicians with prompt diagnostic intervention. An eighty year old male with a history of tobacco and alcohol intake, chronic hypertension and a pulsatile abdominal swelling for one year presented at the Accident and Emergency unit because of constipation, examination revealed a normal blood pressure and a pulsatile mass at the right iliac fossa. Computerized tomography, Duplex studies of the abdominal aorta confirmed the diagnosis of AAA. Unfortunately patient succumbed within 24 hours of confirmation of diagnosis before referral to cardiovascular surgery was effected. AAA occurs in this environment, patients with history of hypertension, smoking, alcohol intake and abdominal swelling should have AAA included in the differential diagnoses, appropriately investigated for timely intervention.
 

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