Subclavian and axillary artery aneurysms are rare occurrences and are associated with serious sequelae if they are untreated. Little is known about these aneurysms, and best practice guidelines are lacking. We describe an 87-year-old man with a history of chest irradiation who presented with radiation-induced subclavian and axillary aneurysms and acute upper extremity ischemia. An endovascular stent graft procedure was undertaken because of his prohibitive high risk for open surgical treatment. Follow-up duplex ultrasound revealed patent stent grafts with complete exclusion of aneurysm sacs. Endovascular therapy is a viable option for upper extremity aneurysms in patients at high risk for open surgical repair.