Primary aortic angiosarcomas are extremely rare. Clinically and radiographically, they mimic atherosclerosis and atheroembolic disease. For a definitive diagnosis, histologic evaluation of the tumor or of peripheral emboli is required. The imaging findings are frequently nonspecific and in most published cases did not allow a definitive preoperative diagnosis. This is the first report of the computed tomographic angiographic findings of a primary intimal abdominal aortic sarcoma and a review of previously described imaging findings in these tumors.