Takayasu arteritis is a chronic granulomatous large-vessel vasculitis primarily affecting the aorta and its major branches such as the subclavian, carotid, and renal arteries. Pathologically, it is characterized by transmural infiltration of lymphocytes and macrophages with granulomatous inflammation, leading to intimal fibrosis and thickening, destruction of medial elastic fibers, and subsequent luminal stenosis or occlusion. In some cases, aneurysmal dilation may occur. In this report, we present a case of TA complicated by a vertebral artery dissecting aneurysm. The patient had previously undergone surgical interventions at our institution 6 years and 2 years prior for a common iliac artery aneurysm and splenic artery aneurysm, respectively. Most recently, the patient presented with right shoulder pain and was subsequently diagnosed with a right vertebral artery dissecting aneurysm, for which endovascular intervention was performed. This case underscores the critical importance of long-term clinical surveillance in TA patients, along with the necessity for aggressive treatment of aneurysms identified as high-risk for rupture.