The splenic artery originates from the superior mesenteric artery in approximately 1% of cases, which may explain the extreme rarity of aneurysms involving this anomalous branch, with only five cases reported in the international literature to date. We report our experience of managing two patients with aneurysms involving splenic arteries arising from the superior mesenteric artery, one treated surgically and the other percutaneously. From a diagnostic point of view, the first approach is ultrasound, while computed tomographic (CT) scan and angiography enable a better definition of the lesion and of the anatomical anomaly; CT angiography is currently the method of choice for the preoperative workup. Finding these two anomalies in association is so rare that it is impossible to draw any final conclusions as to the best type of treatment. In the authors' experience, both surgery and percutaneous treatment can prove useful.