Infected abdominal aortic aneurysm (IAAA) is a catastrophic disease, which is difficult to treat and has a high mortality rate. The goal of surgical treatment is to eliminate the lesion, prevent rupture of the aneurysm and maintain the channels of blood flow. The early and full course of antibiotic medications is the basis of treatment. The traditional surgical procedures that include the in situ prosthetic reconstruction and axillofemoral bypass are consistent with surgical principles. However, the graft infection rate is relatively high after debridement and in situ prosthetic reconstruction, and serious complications such as graft obstruction or aortic stump rupture may occur after axillofemoral bypass operation. Although endovascular procedures are not entirely consistent with surgical principles, the available clinical data suggest that they are still applicable in elderly patients who are unable to tolerate open surgery. Retroperitoneal bypass can effectively reduce graft infection and maintain graft patency, so it is a more rational surgical procedure for IAAA.