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Background   Coxiella burnetii , the causative agent of Q fever, may cause culture-negative vascular graft infections. Very few cases of  C. burnetii  infection of a vascular graft have been reported. All were diagnosed by serology.    Case presentation  We report the first case of  Coxiella burnetii  vascular graft infection diagnosed by broad-range PCR and discuss the diagnostic approaches and treatment strategies of chronic  C. burnetii  infection.    Conclusion   C. burnetii  should be considered as etiological agent in patients with a vascular graft and fever, abdominal pain, and laboratory signs of inflammation, with or without exposure history. Broad-range PCR should be performed on culture-negative surgical samples in patients with suspected infection of vascular graft.