MANY ADVANCES have been made in surgery for abdominal aortic aneurysm since Dubost reported the first resection with homograft replacement in 1952.1 Presently resection with prosthetic graft replacement is considered the treatment of choice and has been employed with a mortality as low as 5% and late survival approaching that for other people of similar age.2 Ruptured abdominal aortic aneurysm, however, constitutes a surgical challenge. Operative mortality as high as 85% has been reported.3 An average hospital mortality of 56% in a recent collective review (Table 1) indicates the need for continued improvement of operative and postoperative management of these critically ill patients, if a higher salvage rate is to be achieved. This study, therefore, was undertaken to obtain a more up to date analysis of surgical experience with this fatal condition and, if possible, determine the factors influencing the results of operative management. Materials and Methods