In this chapter the essential aspects of anesthesia for abdominal aortic aneurysm (AAA) repair are discussed. Subtopics include airway management in expanding aneurysm, hemodynamic therapy, monitoring, vasodilator therapy, and bleeding. The chapter is divided into preoperative, intraoperative, and postoperative sections with important subtopics related to the main topic in each section. Preoperative topics include medications, assessment of cardiac status, and hemodynamic goals for this surgery. Issues discussed related to intraoperative management include monitoring, induction, maintenance, and aortic cross-clamping and unclamping. Postoperative concerns discussed include extubation, decreased renal function, spinal cord ischemia, and other complications affecting the cardiovascular, respiratory, renal, and gastrointestinal systems.