Mesenteric arterial branch aneurysms are rare. Giant, multiple, mesenteric branch artery aneurysms are even more uncommon, and only a few reports exist in the literature. We describe a 73-year-old asymptomatic female found to have an abdominal bruit and subsequently diagnosed with multiple mesenteric branch artery aneurysms by computed tomography and angiography. In addition, the patient was found to have celiac artery occlusion at its origin. Risk factors include hypertension, hyperlipidemia, grandmultiparity, and tobacco dependence. She was treated successfully with open surgery including ligation of multiple branch aneurysms and vein bypass reconstruction to preserve hepatic and mesenteric artery flow. Our purpose is to review this uncommon entity in terms of diagnosis, etiology, treatment options, and literature review.