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Objective: To evaluate the effectiveness of the hybrid graft technique for complicated infrarenal abdominal aortic aneurysms (AAAs)., Methods: The clinical data of 183 patients who underwent endovascular aneurysm repair (EVAR) for AAA with challenging anatomy at Zhongshan Hospital Affiliated to Shanghai Fudan University from 2010 to 2015 were retrospectively analyzed. Endografts were divided into two groups: Hybrid Group (28 cases) used more than one type of stent graft, and Standard Group (110 cases) used only one stent graft type. Patients were recommended to undergo CT angiography at 1, 3, 6, 12 month after the procedure. Clinical data were analyzed with a focus on postoperative hospital stay, endoleak, limb occlusion, complications of approach, complications of system, converted to open operation and secondary intervention., Results: Technical success was achieved in all patients in both groups. Compared with hybrid group and standard group, there was no difference in postoperative hospital stay ((5.35±2.99) and (5.92±3.70) days, t=0.753, P>0.05). During the follow up, there was no difference in endoleak (10.7% and 18.2%), limb graft occlusion (3.6% and 10.9%), complications of approach (0 and 1.8%), complications of system (7.1% and 0.9%), converted to open operation (0 and 0.9%) between two groups (χ(2)=0.896, 1.408, 0.517, 4.078, 0.256, all P>0.05). However, there was statistically significant difference in secondary intervention between two groups (3.6% and 19.1%, 2=4.011, P<0.05)., Conclusion: The use of hybrid stent graft in patients with unfavorable neck and iliac artery anatomy AAA is feasible, and it could improve the postoperative outcomes such as secondary intervention rate.