Background: Abdominal aortic aneurysm (AAA) is a life-threatening condition. Open surgery and endovascular repair are the options for treating AAA. This study aimed to compare the frequencies of in-hospital complications and outcomes in two groups of patients who underwent AAA repair surgery using either an open or an endovascular repair method., Methods: This retrospective study was conducted on the records of 60 patients with AAA undergoing elective surgery repair using endovascular approaches or open surgery at Razi Hospital from 2010 to 2019. Patients' related information, including age, sex, changes in blood pressure, respiratory complications, renal complications, myocardial infarction, paraplegia, cloneischemia, lower limb ischemia, duration of hospital stay in intensive care unit and hospital, the dose of packed RBC, the dose of injectable narcotic analgesics, the need for vasopressor medication, duration of surgery, duration of postoperative oral feeding, and death during hospitalization were assessed., Results: A total of 60 patients in two groups were studied. The mean age of patients was 72.4 ± 6.28 years, and most were male (86.7%). The incidence of renal complications (3.3%) and respiratory complications (0%), rate of decrease in arterial blood oxygen saturation, length of stay in ICU (median 2 vs. 4) and hospital (median 4.5 vs. 7), the need for vasopressor injection and the dose of packed RBC (median 0.4 vs. 3.33), the dose of narcotic analgesic injection (53.3%), duration of surgery (median 2.5 vs. 3), duration of postoperative oral feeding (median 23 vs. 54), and the incidence of death were significantly lower in the endoscopic surgery group., Conclusion: Endovascular surgery repairing the rupture of an AAA is associated with fewer postoperative complications and in-hospital death than open surgery., Competing Interests: None., (AJCD Copyright © 2023.)