Aortic stent graft repair has recently been applied as an alternative therapy for infrarenal ruptured abdominal aortic aneurysms (rAAAs). We retrospectively assessed outcome in a continuous series at a single institution (an academic tertiary referral center) of patients with infrarenal rAAAs treated by either open or endovascular repair. Between October 1999 and July 2004, 24 patients were treated at the University of Alabama Hospital for infrarenal rAAA. They were treated by either open procedure (n = 15) or endovascular stent graft repair (n = 9). Outcome parameters included mortality, morbidity, procedure time, blood loss, and length of stay. Endovascular aneurysm repair (EVAR) was performed whenever the anatomy was deemed suitable and experienced personnel were available. Age (mean 70.8 years for EVAR vs. 72.2 years for open), gender (men 71% vs. women 75%), AAA size (mean 6.7 vs. 6.4 cm), early mortality (22% vs. 26%), and major morbidity (56% vs. 53%) were similar in both groups. Blood loss difference between the two groups was statistically significant (p = 0.0001). Our series supports the feasibility and short-term viability of EVAR for infrarenal rAAA when anatomy is suitable and patient and facility conditions are favorable. © Annals of Vascular Surgery Inc.