Cystic adventitial disease is a rare condition in which a cyst is formed in the wall of an artery and a vein, which can cause narrowing of the vessel. Middle-aged people without risk factors for atherosclerosis are most likely to be affected by the disease. For this group of patients, in the presence of intermittent claudication, radiographic imaging is indicated even if they have palpable pulses in the resting state. The first choice in radiographic imaging should be magnetic resonance imaging; also ultrasound imaging and computed tomography scan are considered feasible. The treatment of a patient with symptomatic cystic adventitial disease is surgical, which is different from the treatment of patients with arterial claudication caused by atherosclerotic disease.