A 59-year-old woman was referred to our hospital with a complaint of a pulsatile mass in the right inguinal region four months after total hip replacement. Right femoral arterial injury owing to continuous contact with a fold of excess cement used in the fixation of the hip prosthesis was suspected to be the cause of the false aneurysm. Moreover, two months after the total hip replacement, the right lower leg was amputated at the below-knee level for acute ischemia due to arterial thromboembolism probably originating from the false aneurysm. False aneurysm due to direct vascular injury deserves consideration as a possible complication of total hip replacement.