Background: Vascular system complications are an ongoing hazard of intravenous drug abuse. Patients and Method: This is a prospective study. The study was conducted on twenty patients who were presented at AL Hussein University Hospital in Cairo with infected femoral artery pseudoaneurysm over a period of eight months from Nov 2017 to July 2018. The inpatient medical charts were reviewed. Data were obtained on their demographic, clinical, management and outcome parameters. Result: Among the twenty intravenous drug users presenting with infected femoral artery pseudoaneurysms, (16) of the patients (80%) were seropositive for HCV. All were operated, with (5%) mortality. Primary ligation and debridement was the technique used almost exclusively (75%). One patient was managed by primary reconstruction by direct in-situ repair. Four patients were managed by primary revascularization through exta-anatomical bypass. Mean follow up period was three months. Conclusion: Ligation and debridement appears to be a simple, safe and effective procedure in infected pseudoaneurysms in IV drug users.