PURPOSE To demonstrate the feasibility of endovascular repair of a ruptured abdominal aortic aneurysm (AAA) previously treated with an endoluminal stent-graft. CASE REPORT An 84-year-old man with a 9.5-cm AAA underwent endoluminal repair with an Endologix stent-graft, but a type I endoleak was detected postprocedurally. The patient was discharged and lost to follow-up. Twenty months later, he suffered an aneurysm rupture, which was repaired using endovascular techniques. Although he had a postoperative course complicated by aspiration pneumonia and renal failure, he recovered fully and was discharged from the hospital with no evidence of endoleak on the postprocedural imaging studies. CONCLUSIONS Late ruptures after endoluminal AAA stent-grafting can be successfully treated with endovascular techniques.