BACKGROUND AND OBJECTIVE: Endovascular aortic aneurysm repair (EVAR) is a relatively new technique as compared to open surgery (OS). The objective of this meta-analysis was to evaluate the safety and efficiency of this procedure for patients having abdominal aortic aneurysm (AAA). METHODS: We systematically analyzed 55 articles in accordance with inclusion criteria. A total of 1888 patients with 1321 undergoing OS and 567 undergoing EVAR were reported in literature. Outcomes (endoleak,

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... ic leak, renal, pulmonary, cardiac, multi organ complication and stroke) of these two procedures for these patients were compared. RESULT: No significant difference has been reported between two procedures with respect to success rates, operating time, intensive care unit (ICU) stay, and postoperative hospital stay. Blood loss and blood transfusion requirements were significantly lower in the EVAR group. Differences were found in the rates of cardiac, renal, pulmonary, and visceral complications, which were all more frequent in OS group (P= 0.01. Lower limb ischemia was more common in EVAR group (P <0.05). Mortality at 30-days, was higher in the OS group than EVAR group (P <0.05). CONCLUSION: EVAR is a feasible, safe and less invasive treatment for aortic aneurysm and patients have a quick recovery with fewer complications.