To assess the efficacy of ultrasound-guided compression repair (UGCR) in postcatheterization femoral artery pseudoaneurysms. One hundred thirty-three patients with pseudoaneurysms were considered for UGCR. Patients underwent compression with duplex and color Doppler ultrasound. Immediate and long-term successes were evaluated. Seven patients were not candidates for UGCR. UGCR was technically possible in 117 of the 126 patients who were candidates. UGCR was successful in 109 patients. The failure rate was significantly higher in patients who were receiving anticoagulant medication (P < .001). Pseudoaneurysm size, age, and structure (simple vs multiloculated) had no bearing on success or failure. The time required for successful compression was not related to treatment with anticoagulants but was related to pseudoaneurysm structure. Complications included one case of a distal embolus and two episodes of hypotension. UGCR is a simple and expedient method for the treatment of postcatheterization femoral artery pseudoaneurysms.