Objective: To compare the therapeutic effects of endovascular and open surgery on abdominal aortic aneurysms. Methods: From June 2019 to May 2020, 60 cases of abdominal aortic aneurysms (AAA) were divided into observation group (30 cases in endovascular technique group) and control group (30 cases in open technique group). Results: The blood loss, operative time and blood transfusion of the observation group were significantly lower than those of the control group (P<0.05). The incidence of postoperative complications is low, and the incidence of long-term complications is relatively high. Conclusion: In the treatment of abdominal aortic aneurysm, endovascular technology has the advantages of low risk, less trauma, and quick recovery after surgery. Open surgery is suitable for patients who cannot receive endovascular treatment. In order to achieve good treatment effects, it is necessary to choose an appropriate treatment method according to the actual situation of the patient.