Review of the most significant surveys (data base: Pub Med on september 2003) of elective open surgery for Juxtarenal aneurysms and personal results of 106 cases (9,3% of AAA consecutively operated in the last 11 yrs.) are reported. Mortality and morbidity are discussed related to: technique of aortic cross-clamping; protective measures on splanchnic and renal perfusion; risks from previous CAD and chronic renal failure. Over all, the main predictive factor is the accuracy of the selected technique, without any difference among different approaches, and the same results of infra renal aneurysms can be obtained.