This motion picture videotape depicts the emergent endovascular treatment of ruptured abdominal aneurysm and ruptured para-renal abdominal aortic ulcer. Two cases (patients) are presented. Both of these cases involve patients brought for treatment directly to the operating room in emergent fashion secondary to shock. These patients had preoperative abdominal CT scans performed at outlying hospitals prior to their transfer. They were then taken to the operating room and underwent successful endovascular stent graft placement (AneuRx). Both of these patients did well postoperatively, eventually being discharged to home. Postoperative CT imaging of the abdomen/pelvis is shown at the end of the videotape. The emergent treatment of ruptured abdominal aortic pathology with "off the shelf" endovascular stent grafts is discussed.