Between January 1974 and April 1986, 440 patients underwent elective or emergency repair of abdominal aortic aneurysms at this hospital. Acute renal failure requiring dialysis following repair occurred in 32 patients (7.3%) and form the basis of this report. All were male patients of mean age 69 years; 21 (66%) gave a history of other major medical problems and 19 (59%) used medication for these medical conditions. Twelve patients (37.5%) survived to leave hospital. No differences were observed between survivors and non-survivors with regard to age, previous medical condition, drug therapy, or creatinine value on admission. Mode of presentation, duration of surgery, frequency of hypotension and number of blood transfusions were similar in both groups. Total hospital stay and duration of intensive care were distributed equally between the two groups. Those who survived seemed to require less inotropic support and a shorter duration of ventilation than the non-survivors; the continued need for these support and persistent leucocytosis greater than 15,000/mm3 were associated with little chance of survival.