OBJECTIVES: In abdominal aortic aneurysm (AAA) an endovascular procedure (EVAR) was introduced challenging the gold standard of open repair (OR). RCTs comparing them from 1999 onwards showed benefit in 30-day mortality for EVAR. Due to additional experience with EVAR; complication rates and resource consumption may have improved. The aim of this study is to assess the efficacy, safety and resource use in the first year post EVAR in a current population compared to the EVAR populations included in RCTs. METHODS: Efficacy, safety and resource use data were collected retrospectively for patients undergoing EVAR from 2004, with at least one year follow-up. Patient population was designed to match the published trials in terms of age, AAA size, and suitability for surgery. Descriptive statistics were used with normative data, mean, minimum and maximum value, number of patients with valid data and 95% confidence intervals calculated for continuous and frequencies for discrete data. RESULTS: A total of 149 patients' records from UK and Dutch hospitals were analyzed. Patients in the study were similar in terms of age and gender to the published trials, but higher proportion had additional risk factors (diabetes, cardiac, renal and pulmonary disease). Inpatient and long-term results suggest lower all cause mortality in the current population compared to published trials. Preoperative stay was longer (2.8 vs. 1.9 days) in the retrospective data, while post-operative hospital stay was shorter (6.4 vs. 6-8.4 days). Time spent in the operating theater was 14-36% lower. Despite similar general (systemic) and EVAR related complication rates, fewer patients required conversion OR (0% vs. 1.5%) or re-interventions (10.1% vs. 15%). CONCLUSION: Although this study was not comparative and prospective, results indicate that, due to additional experience, current EVAR procedures may have improved efficacy, decreased resource use and increased cost-effectiveness, compared with published trials undertaken earlier in the uptake of EVAR.