For abdominal aortic aneurysm (AAA), open and endovascular repair are two currently available treatment methods. How to select an appropriate procedure so as to ensure a quick and safe recovery of the patients is now the focus of attention. In this paper, the scenarios that include the indications, preoperative assessment, complications, mortality and survival as well as cost-effectiveness of the two methods are compared, and the importance in rational choice of procedure is discussed. It is pointed out that there should be continual improvement in endovascular techniques while not abandoning the traditional open surgery, and the most suitable procedure for the patients should be based on the surgeon's skills and prevailing conditions, rigorously following the surgical indications and objective evaluation with the purpose of achieving the greatest benefit for the patients.