AIM OF THE STUDY: This article summarizes our experience in endovascular repair of abdominal aortic aneurysm in octogenarian patients. MATERIAL AND METHODS: From January 2000 to December 2005 30 patients (mean age 84 years) underwent endovascular repair of abdominal aortic aneurysm; in 28 cases a loco-regional anaesthesia has been performed. Twenty-eight bifurcated graft, one straight graft and one aortouniliac graft have been used. RESULTS: No operative mortality or early endoleak have been observed; during the follow-up period (20 months) 7 endoleaks (3 cases type I; 4 cases type II) have been reported; all patients with type I EL underwent endovascular repair; in two patients with type II EL we observed spontaneous regression; the other cases are still monitored in absence of sac enlargement. Four graft occlusions have been observed; one early thrombosis has been treated with surgical thrombectomy, two of the three late occlusions required other procedures. Five patients died during the follow-up period, three of them during the first year. No death has been aneurysm related. DISCUSSION: In accord with other recent studies, our analysis confirms the positive impact on intra-operative and early post-procedural mortality of the endovascular therapy for abdominal aortic aneurysm in octogenarian patients; no evidence of significative benefit on late survival has been observed. CONCLUSION: In conclusion we consider endovascular option as the best approach in octogenarian patients even if a longer follow-up is mandatory.