OBJECTIVE Endovascular repair (EVR) of abdominal aortic aneurysm (AAA) has many potential advantages, one of which may be reduced blood product requirements. The aim of this study was to compare the current blood product usage in our unit for three types of elective operation: EVR of AAA, open AAA repair and femorofemoral crossover grafts. METHODS Prospective data analysis with historical controls. METHODS One-hundred and thirty-two patients undergoing elective EVR of AAA, 35 patients undergoing elective open repair of AAA and 37 patients having femorofemoral crossover grafts. METHODS Data was collected on the blood product requirements of patients having EVR of AAA, with open AAA repair and femorofemoral crossover graft providing historical controls. RESULTS There was no difference in the haematological parameters preoperatively between the three groups but postoperatively patients having EVR had a slightly lower haemoglobin than the open group (10.6 g/dl vs. 10.85 g/dl, p = 0.015). The number of patients who received blood transfusion in the EVR group was 82/132 (62%) and the open group 27/35 (77%), p = 0.4. CONCLUSIONS Patients undergoing EVR of AAA require blood transfusion in the same numbers when compared to those undergoing open repair.