Objective: To observe the outcome following exclusion of internal iliac artery (IIA) during operation of abdominal aortic aneurysm (AAA). Methods: The clinical data of 108 AAA patients undergoing surgical treatment in Xiangya Hospital form June 2010 to June 2014 were retrospectively analyzed. Of the patients, 44 cases were subjected to open surgery, 61 cases received endovascular aneurysm repair (EVAR) and 3 cases underwent hybrid surgery. Seven patients underwent bilateral IIA ligation and 8 patients underwent unilateral IIA ligation in those undergoing open surgery, and 3 patients underwent bilateral IIA coverage and 5 patients underwent unilateral IIA coverage in those undergoing EVAR. Results: No intraoperative death occurred, and 6 cases died within perioperative 30 d but none of them was due to the IIA treatment. Among the 10 patients undergoing open bilateral IIA ligation or endovascular bilateral IIA coverage, one case (1/10) developed symptoms of rectal ischemia that was alleviated after one-month of anticoagulation and vascular dilation therapy, and a short-period of gluteus pain occurred in two cases (2/10), which disappeared by conservative treatment; no intermittent claudication occurred. No symptoms such as rectal ischemia, gluteus pain or intermittent claudication occurred in any of the patients who underwent open unilateral IIA ligation or endovascular unilateral IIA coverage. Conclusion: During surgery for AAA, unilateral IIA ligation or coverage exerts no obvious influence on postoperative condition, whereas bilateral IIA ligation or coverage may cause the symptoms of pelvic ischemia such as rectal ischemia and gluteus pain that can be resolved by conservative treatment.