This is a video case report of a patient who presented with a 7.4cm infrarenal abdominal aortic aneurysm (AAA). Pre-operative CTA demonstrated an occluded celiac artery at its origin and an enlarged inferior mesenteric artery (IMA) providing collateral blood flow to the celiac artery and its branches. Meanwhile, the superior mesenteric artery (SMA) was mildly stenotic at its origin and patent throughout its course. Furthermore, the SMA remained independent of this novel collateral vessel. The patient was taken to the operating room for an open AAA repair with IMA re-implantation in order to preserve this collateral blood flow to the celiac trunk. The IMA was dissected from the aorta as a Carrel patch and implanted onto a Dacron tube graft. The video depicts key steps to the procedure including exposure, anastomosis and closure.