Two hundred patients with ruptured aneurysms of abdominal aorta and iliac artery were operated between 1979 and 1988. There were 179 males and 21 females with a mean age of 69 years (range 51 to 90 years). A total of 53/200 (27%) patients died in the hospital; of these 12/200 (6%) died intraoperatively. In following groups mortality was significantly higher: age greater than 70 years (37% vs 17%; p less than 0.01), preoperative shock (36% vs 14%; p less than 0.01), duration of symptoms greater than 12 hours (33% vs 17%; p less than 0.01), operative time greater than 240 min (53% vs 20%; p less than 0.01), intraoperative resuscitation (83% vs 21%; p less than 0.01), amount of volume greater than 4 liters (29% vs 12%; p less than 0.01) and intraperitoneal rupture (40% vs 24%; p less than 0.05). Location of rupture (suprarenal, infrarenal, iliac vessel), location of aortic clamping and the experience of the surgeon also influenced mortality but not significantly.