We describe a case of arteriovenous fistula developing at the site of balloon dilatation immediately after percutaneous transluminal angioplasty of the superficial femoral artery. This occurred during an otherwise uncomplicated angioplasty. The fistula was treated by inflating a slightly larger balloon with a good clinical result as confirmed by color Doppler ultrasound. This uncommon complication of angioplasty is not widely recognized.