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Lumbar artery pseudoaneurysm is a rare vascular complication of trauma. This case report concerns a 24-year-old man with a lumbar-level spinal cord injury (SCI) secondary to a gunshot wound who developed severe exacerbation of low back and flank pain during inpatient rehabilitation. Diagnostic investigations at an acute care hospital revealed a left lumbar artery pseudoaneurysm. This was treated by transcatheter embolization, which resulted in a marked reduction in pain. The patient resumed inpatient rehabilitation without further complications. This case report highlights the importance of early diagnosis of lumbar artery pseudoaneurysm, a potentially fatal complication that can occur in patients with traumatic lumbosacral SCI. Physiatrists should include lumbar artery pseudoaneurysm in the differential diagnosis for back, flank, or abdominal pain in this patient population., (Copyright 2003 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation)