Tuberculous aneurysm is a rare form of tuberculosis outside the lungs and has a very high mortality rate [1]. Diagnosing tuberculous aneurysms can be challenging. Tuberculous aneurysms of incidence are less than 1 %, and they are rarely encountered in countries where tuberculosis is not endemic [2]. Tuberculous aneurysms can occur without pulmonary tuberculosis [3]. If complicated with lymphadenitis, a lymph node biopsy may help diagnose [4]. However, it is difficult to diagnose it before surgery unless a tissue sample is obtained from the infected site. In most cases, diagnosis is confirmed through a pathological examination of the vessel wall after the surgical replacement of the vascular prosthesis. Additionally, it is not always possible to identify Mycobacterium tuberculosis from lymph nodes or vascular tissue [3]. The rarity of this disease and the difficulty in microbiological diagnosis make diagnosing tuberculous aneurysms challenging. The rupture of an aneurysm can also lead to death [5]. The most established treatment for tuberculous aortic aneurysms involves a combination of surgical and medical interventions [6]. In the reports of the 2000s, endovascular therapy with stent grafts for aneurysms was effective and safe [7]. We here report a case of this rare extrapulmonary tuberculosis known as a tuberculous aneurysm, which is usually fatal. After the stent-graft replacement, the patient underwent her CT-guided biopsy for histological and microbiological diagnosis and was cured with anti-tuberculous therapy for nine months. Diagnosis of tuberculous aneurysms is difficult, but CT-guided biopsy may become an essential method for diagnosing tuberculous aneurysms in an era where stent-graft replacement therapy is the standard treatment for aneurysm rupture.