The importance of following a prioritized sequential approach to patients with complex multianeurysm disease cannot be overemphasized. The following patient with multiple visceral aneurysms first had coil embolization of bilateral renal artery aneurysms and then operative excision of her remaining splenic artery aneurysms to minimize the potential morbidity of a larger operation. This case also demonstrates the potential for following levels of specific degradative enzymes associated with aneurysmal disease (matrix metalloproteinase-9 (MMP-9) in this case) preoperatively and postoperatively and in long-term follow-up to monitor for disease recurrence.