Historically, superficial venous aneurysms of the lower extremities are considered rare. However, owing to the increased use of duplex ultrasound imaging, these entities are being recognized more frequently. The clinical significance of superficial aneurysms is poorly defined; yet, pulmonary emboli arising from superficial aneurysms have been reported. Symptomatic patients typically complain of the sequelae of reflux, such as edema, pain, mass, and varicosities. Current treatment consists of simple open excision. We report two cases of small saphenous vein aneurysm and provide review of its pathophysiology, presentation, diagnostic evaluation, and therapy.