To determine 30-day mortality of endovascular aortic balloon control compared to open aortic cross clamp in open surgical repair of ruptured abdominal aortic aneurysms. A retrospective cohort review was performed of all adult patients who underwent open surgical repair of an infrarenal rAAA between 2001 and 2018 at a single tertiary care center. 174 patients were identified, of which 21 patients received endovascular aortic balloon control and 137 patients received an open aortic cross clamp. Primary outcome was 30-day mortality. Two-variable multivariate logistic regression was adjusted for preoperative blood pressure and age. Endovascular aortic balloon control was non-significantly associated with lower mortality (adjusted OR = 0.75 [95%CI 0.24-2.38], p=0.63), and when placed under local anesthesia showed a trend towards improved mortality (adjusted OR = 0.34 [95%CI 0.06-1.77], p=0.19). Balloon placement under general anesthesia was non-significantly associated with worse mortality (adjusted OR = 2.50 [95%CI 0.35-9.13], p=0.46). There is no significant different in mortality with the use of endovascular aortic balloon control in rAAA patients undergoing open surgical repair, and it may be considered as an alternative approach to open aortic cross clamp in properly selected patients.