Endovascular repair of abdominal aortic aneurysms has become part of the standard of care for those patients with appropriate anatomy. Since its initial reporting in 1991, numerous devices have been manufactured and undergone various stages of clinical trials and subsequent postmarket use. Currently, there are four commercially available devices. Without exception, all of the devices are subject to late failure and complications, and, therefore, diligent postoperative surveillance is mandatory. Some of the failure modes apply to the therapy itself and some are device-specific. These failure modes shed light into the unmet needs of the current technology and directions for further improvement.