Objective To investigate the safety and efficacy of endovascular abdominal aortic aneurysm repair(EVAR)in nonagenarians. Methods From May 2003 to March 2011, 12 nonagenarian abdominal aortic aneurysm(AAA) patients, including 2 emergency cases, were treated with endovascular repair. Mean age was (91.7±1.5) years, ranging 90～95 years, and there including 2 emergency cases, were 11 males (91.7%). Technical success rate, perioperative complications and mortality were evaluated. Follow-up protocol consisted of computed tomography (CT) or ultrasound examinations performed at 3, 6, 9, 12 months, and annually thereafter. Results Seven patients were operated under general anesthesia and five under local anesthesia. The technical success rate was 100%, with no need for open conversion. Two Endurant endogafts, four Talent endografts and six Zenith endografts were used. Mean operatiion time was (3.4±1.3)h, mean procedural blood loss was (220.5±60.5)ml, and mean postoperative hospital stay length was (8.4±2.3)d. Mortality rates were 8.3% at 30 days, 16.7% at 1 year, 41.7% at 3 years and 75% at 5 year. Mean survival of the eleven patients who expired beyond the first 30 days was 28.5 months, ranging 9～73 months. Conclusion EVAR in nonagenarians is associated with acceptable procedural success and perioperative morbidity and mortality. The medium and long-term results suggest that EVAR may be of limited benefit in some patients who are aged over 90 years. So the individual patient selection is very important.