Congenital aneurysms of the palm are uncommon in the pediatric population compared to aneurysms in adults. A seven-month-old boy presented with a true aneurysm of the ulnar artery with reconstruction with surgical excision and end-to-end microvasculer anastomosis using a superficial vein of the dorsal foot. To our knowledge, there have been only 15 reports of congenital aneurysms of the palm.