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A 70-year-old man was admitted to the hospital because of melena and hypovolemic shock. A preoperative diagnosis of aortoenteric fistula was made by imaging assessment. Embolization of the origin of the right common iliac artery was performed, and the gastrointestinal bleeding stopped. After the patients cardiorespiratory function had become stable, laparotomy was performed. It revealed an ilioappendiceal fistula through the iliac artery aneurysm. The fistula was closed, the appendix was resected, and the aneurysm was satisfactorily dissected. Aortoenteric fistula is generally a rare entity. The prognosis is thought to be poor because of the difficulty of early diagnosis and complication by sepsis. We report a case of common iliac artery aneurysm with ilioappendiceal fistula in which the patient's life was saved by embolization and operation.