Pseudoaneurysm formation in a renal transplant is an uncommon complication of such interventional procedures as percutaneous nephrostomy or renal biopsy; symptoms may be delayed for days or even years. Presentation may vary from incidental discovery to worsening renal insufficiency to life-threatening hemorrhage. We report a case of macroscopic hematuria from a pseudoaneurysm that developed in a kidney transplant recipient after placement of a percutaneous nephrostomy tube. This patient was treated with transcatheter embolization, which is highly effective. A high index of suspicion, along with early diagnosis and transcatheter embolization, are essential for the management of hematuria caused by pseudoaneurysm formation from percutaneous nephrostomy tube placement.