Visceral artery true aneurysm (VAA) and visceral artery pseudoaneurysm(VAPA) are rare with a reported incidence of 0.1 to 0.2 percent. The most commonly involved arteries were splenic artery and hepatic artery. Most VAAs and VAPAs are asymptomatic. The most common symptoms are malaise, vague abdominal pain, and nausea or vomiting. Their nonspecific symptoms and signs may cause a delay in diagnosis. Ultrasonography and cross-sectional abdominal vascular image is required for patient in whom the diagnosis is suspected. This report presents a case of giant splenic artery true aneurysm with presentation of acute onset of persistent severe abdominal pain.