In the 16 year period ending December 1985, 332 patients underwent elective abdominal aortic aneurysm replacement. One hundred fifty-four (46 percent) of these patients had tube graft replacement of the aneurysm. Patients were selected for tube graft on the basis of physical, angiographic, and intraoperative examinations. There were 123 mean and 31 women, with a mean age of 68 years. Complete follow-up ranging from 1 to 168 months (mean 53 months) was obtained in 137 of the surviving patients (87 percent). Two patients required revision to a bifurcated graft; one for iliac stenosis and one for iliac thrombosis. No iliac aneurysms were seen and no other aortoiliac complications were evident. Five other patients required femoro-distal reconstruction for either occlusive disease (three patients) or aneurysmal disease (two patients) at the groin or below. Life table analysis showed a 5 year survival rate of 65 percent and a 7 year rate of 54 percent. Conclusions drawn from this study reconfirm that in carefully selected patients, tube graft replacement of abdominal aortic aneurysm is an enduring procedure with few complications developing due to progression of iliac occlusive or aneurysmal disease.