BACKGROUND: The involvement of a aneurysm or pseudoaneurysm in vascular Behçets disease (BD) is rare and difficult to treat. The present study investigates the definitive therapeutic strategy for aneurysm with vascular BD. Case presentation: We report three cases of BD with aneurysm in different arteries. All patients underwent endovascular surgery, but the treatment effects were different. Two patients developed new aneurysms immediately after surgery, and eventually died due to rupture of recurrent aneurysm, while merely one patient survived after endovascular treatment. CONCLUSION: For aneurysms involved in vasculo-Behçets disease (v-BD), endovascular treatment is suggested during the stable period. At the same time, glucocorticoids and immunosuppressants could be preoperatively and postoperatively used together.