Objective: To investigate the approach and efficacy of transobturator bypass surgery in treatment of infected femoral artery pseudoaneurysm. Methods: The clinical data of 4 patients with infected femoral pseudoaneurysm undergoing transobturator bypass surgery from August 2004 to July 2014 were retrospectively analyzed. Results: Of the patients, 3 cases were male and one case was female, with an average age of 26.5 (22–31) years. The cause for the pseudoaneurysm in 3 cases was femoral artery injury due to addictive drug injection and in one case it was a complication in the puncture site of arterial embolization therapy of the lower extremity. Three cases underwent simple femoral artery ligation and debridement of the infected aneurysm, and then second stage transobturator iliacofemoral bypass after the occurrence of postoperative lower limb ischemia; one case underwent femoral artery ligation and debridement of the aneurysm, and synchronous transobturator external iliac-superficial femoral bypass. The average fellow-up period was 27 (8–60) months, and the ankle brachial index (ABI) of the affected limbs of the 4 patients ranged from 1.0 to 1.1 after the procedure, and no intermittent claudication or other discomforts were noted. Conclusion: Primary or staged transobturator bypass surgery for infected femoral artery pseudoaneurysm can avoid postoperative ischemia of the lower limbs.