Objective To analyze the early outcome of juxtarenal abdominal aortic aneurysms(AAA) repair with fenestrated endovascular stent graft. Methods Four juxtarenal AAA patients with severe comorbidities who were not suitable for open surgery were included. Fenestrated endovascular stent graft was customized according to CT data. The stent graft was implanted together with two small stent grafts into the renal arteries under general anesthesia. Results After operation, digital subtraction angiograph(DSA) showed the patency of the visceral arteries and the renal arteries and favorable morphology of the stent graft. Minimal proximal typeⅠendoleak was found in 2 cases. The follow-up results at 3 months after the operation showed that the morphology of the stent graft was normal in all 4 patients; typeⅠendoleak found immediately after the operation in two patients disappeared; type Ⅱ endoleak was detected in another patient. Conclusion Fenestrated endovascular stent graft yields satisfactory short-term therapeutic effects on patients with juxtarenal AAA.