In an eight-year interval, 40 consecutive ruptured abdominal aortic aneurysms were surgically resected in a community hospital. The resulting 43% mortality (18 patients) compares favorably with those reported from the larger university hospitals. A review of cases suggests that a successful surgical outcome depends on many variable factors, but speed in diagnosis and operation still remain the mainstays of success. Since a survival rate of 98% for elective aneurysm resection was obtained in 100 patients during the same eight-year period, we proposed a diligent search for all asymptomatic aneurysms and elective resection.