Fifty-six patients with a ruptured abdominal aortic aneurysm presented to an acute general hospital over six years from 1968 to 1973. Twelve patients died before operation, while 19 of 44 patients (43%) survived replacement of the aneurysm with a Dacron graft. Patients aged under 70 years and not shocked on admission to hospital had the best chance of survival. It is suggested that survival rates can be significantly raised only by a decrease in the time between the onset of symptoms and an operation. A correct diagnosis may be made more often if it is remembered that the classical clinical triad of pain, shock and an abdominal mass is seen is less than half of the cases presenting to hospital.