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An aorto-caval fistula caused by a ruptured false aneurysm of the abdominal aorta was reported. A 70-year-old male who had a history of aorto-femoral bypass was admitted because of right lower abdominal pain. Enhanced computed tomography scans revealed aorto-caval fistula. The patient exhibited high output heart failure and acute renal failure. Stent-grafting for abdominal aorta was performed. Intra- and postoperative examination revealed no leakage from the aorta to the vena cava. Endoluminal treatment for aorto-caval fistula is efficacious as less invasive treatment.

Management of an aorto-caval fistula from a ruptured aortic false aneurysm using a covered stent graft