Cystic adventitial disease (CAD) is a rare condition caused by a cystic abnormality of the adventitia. It is most commonly found in young or middle-aged adults without significant risk factors for peripheral arterial disease. The disease usually affects the popliteal artery and can present with intermittent claudication. We present a case of CAD of the popliteal artery in a 65-year-old man and describe its treatment. For symptomatic patients, treatment of choice remains surgical resection of the cyst through a posterior approach.