Objective: To investigate the technical essentials and efficacy of endovascular aortic repair (EVAR) in treatment of complex infra-renal abdominal aortic aneurysm (AAA). Methods: The clinical data of 15 patients with complex infra-renal AAA undergoing EVAR were reviewed, and the technical essentials and clinical outcomes were analyzed. Results: The technical success rate of the operation was 100%, without any open conversion. One patient (6.67%) died of acute heart failure 5 days after EVAR. In 2 patients with severe angulation of aneurysmal neck, the operation was completed by brachial-femoral guidewire insertion; in 7 patients with iliac artery stenosis, 4 cases underwent brachial-femoral guidewire insertion and stent placement after balloon dilatation, and in the remaining cases operation was completed by balloon dilatation only; one patient with left iliac artery occlusion was recanalized by leading the guidewire through the occluded segment from the contralateral iliac artery; 8 patients with severe iliac artery distortion underwent correction of the distorted segment by super-hard guide wire and then had stent deployment. No serious complications such as aneurysmal rupture, vascular penetration and iatrogenic dissection occurred during operation. During follow-up, one patient developed spinal tuberculosis 2 years after the surgery and died of multiple organ failure, endoleak occurred in 3 patients and one patient received a second surgical intervention. Conclusion: With the accumulation of experience, technical progress and continued stent development, EVER is feasible and effective therapy for complex infra-renal AAA.