Abdominal aortic aneurysm (AAA) is a complex aortic disease affected by multiple risk factors. The present studies on AAA mainly focus on the role of blood disorders, inflammation, oxidative stress, and endothelial mechanical sensors in the development of AAA, but the pathogenesis of AAA remains unknown. Aortic microcirculation is one of the important sources of blood perfusion and oxygen in the arterial wall. In recent years, an increasing body of evidence has shown that dysfunction in aortic microcirculation may plays an important role in the development, treatment, and prognosis of AAA. Therefore, exploring the possible microcirculatory pathogenesis in the progression of AAA contributes to the understanding and development of adjuvant therapeutical strategies targeting microcirculation for AAA, implying important value in translational medicine.