Objective To investigate the endovascular treatment for abdominal aortic aneurysm (AAA) complicated with iliac artery disease. Methods A total of 52 AAA patients who received endovascular treatment in our department from January 2008 to December 2016 were enrolled in this study. Their clinical data, such as sex, age, clinical characteristics (including coronary heart disease, hypertension, diabetes, hyperlipidemia), and patency of deep and superficial femoral artery were collected and analyzed retrospectively. According to the severity of iliac artery disease, they were divided into patent iliac artery group and stenosis or occlusion iliac artery group. All patients received endovascular treatment and futher anticoagulation or antiplatelet after operation to prevent atherosclerosis. According to the data types, Student’s t test or Chi-square test (Fisher exact probability method) was used to compare the differences between groups. Results Fifty-two were divided into patent iliac artery group (41 patients, including 2 patients with severe distortion, 3.8%,2/52)and stenosis or occlusion iliac artery group(11 patients,9 patients with iliac artery stenosis, 17.3%,9/52, and 2 patients with iliac artery occlusion, 3.8%,2/52),there were no significant differences in sex, age, clinical characteristics, and patency of deep and superficial femoral artery between the 2 groups of patients (P>0.05). Two groups underwent endovascular exclusion successfully. Among patent group, distortion were corrected by super-hard guide wire, and in stenosis or occlusion group, balloon dilation and retrograde expansion of the femoral artery was carried out in affected limb or contralateral side. Stent were placed successfully for two groups. All patients were followed up for 12 to 24 months. Two patients had occlusion of lateral iliac artery in stenosis or occlusion group (P<0.05), among which one was treated with 1 leg brace in the right iliac artery and sequentially artificial vessel bypass in bilateral femoral artery, and the blood supply of both lower limbs was good after operation. Conclusion Being complicated with iliac artery disease makes it difficult for endovascular repair of abdominal aortic aneurysm. Endovascular exclusionwill be achieved successfully in cases receiving practical collaboration of surgical skills and instruments, and long-term patency rate was well.