Arterial manifestation of Behçet disease represents a challenging clinical scenario with a potential for fatal complications. This case depicts the surgical management of a 4.5-cm infrarenal aortic aneurysm and a 6-cm left renal artery aneurysm in a patient with known Behçet disease. The presence of a contralateral living donor kidney transplant added to the complexity of the case. Open surgical repair was performed on both aneurysms with the use of axillofemoral bypass to protect the transplanted kidney. This case highlights the challenges of treating an aortic aneurysm in a patient with Behçet disease and a kidney transplant.