Minimally invasive surgery (MIS) has been recognized as increasingly beneficial to patients undergoing various cardiovascular surgical procedures. Cardiac applications with MIS techniques and technologies are being shown as beneficial in heart valve replacement and in coronary artery bypass. In vascular surgery, benefits are being reported for endoscopic saphenous vein harvesting as well as endoscopic ligation of incompetent perforators. Since 1993, applications of laparoscopy to aortic surgery have been reported. Until these reports, percutaneous interventional procedures have been the mainstay of MIS vascular work for aortoiliac disease. Reported laparoscopic techniques have ranged from laparoscopically assisted techniques to procedures performed completely laparoscopically. Several studies show that laparoscopic aortic surgery is feasible. These show the known advantages of MIS for patients, with decreased use of analgesics, shortened ileus, earlier ambulation, and shortened length of stay. Laparoscopy has been showing a growing role in the armamentarium of the modern vascular surgeon.