Background/Purpose Hepatic artery pseudoaneurysms, particularly extrahepatic, are a rare complication of blunt hepatic trauma, typically presenting in a delayed fashion. This presentation highlights a case and discusses the literature surrounding routine CT surveillance following non-operatively managed blunt hepatic injury. Case Presentation/Methodology A 40-year-old male presented to a trauma centre after a 6-metre fall from a construction site with multiple injuries including a grade IV liver laceration centred around the porta hepatis. This liver injury was managed non-operatively. On day sixteen of admission, he had a sudden cardiac arrest from haemorrhagic shock with a subsequent CT demonstrating a ruptured extrahepatic proper hepatic artery pseudoaneurysm. Despite laparotomy and vessel repair, he died from pulmonary complications of aspiration pneumonia and acute lung injury associated with massive transfusion. A literature search was conducted of evidence surrounding utility of surveillance CT to detect hepatic artery pseudoaneurysm after blunt hepatic injury. Results/Discussion There were conflicting views regarding the utility of repeat CT to detect a pseudoaneurysm in asymptomatic, non-operatively managed patients with blunt hepatic trauma. In particular, the literature does not distinguish the utility of repeat routine CT for intrahepatic and extrahepatic hepatic artery pseudoaneurysms, the latter if which is rarer. Current guidelines recommend against it, but there are observational studies suggesting utility, particularly in high grade (≥IV) liver injury. Conclusion In patients with a high-grade injury extending to the porta hepatis, repeat imaging should be considered to detect possible pseudoaneurysm.