A retrospective study of 105 patients with ruptured aortic aneurysms treated by surgery over 15 yr was undertaken. The mortality rate was 58%. A high incidence of cardiorespiratory disease, delay in treatment caused by wrong diagnosis and preoperative shock were some of the factors responsible. All patients with ruptured aneurysm were operated on, unless moribund. No patient was refused surgery because of age or concomitant disease, unless it seemed that life expectancy from such disease was short. During the same period, 221 patients had elective aneurysmectomies, with a mortality rate of 6.3%, indicating that, with a few exceptions, all abdominal aortic aneurysms should be resected.