Lifelong surveillance is recommended for endovascular aneurysm repair (EVAR) and acute, uncomplicated type B thoracic aortic dissection, although compliance remains a significant challenge. We sought to determine factors associated with failure to obtain recommended surveillance. Patients surviving to discharge, who received EVAR for thoracic or abdominal aortic aneurysms or medical management for type B dissections, from 2004 to 2011 were reviewed. Primary end points were compliance with follow-up and need for reintervention. Comorbidities included coronary artery disease, congestive heart failure, hypertension, chronic obstructive pulmonary disease, diabetes, and chronic kidney disease. Socioeconomic factors examined were age, sex, distance from hospital, discharge destination (ie, home, with or without home health or family assistance, or skilled nursing facility), and insurance type. Complications included endoleak, sac expansion, endograft migration, infection, thrombosis, and aneurysm degeneration. We identified 157 patients (median age, 72.5 years); of these, 127 had EVAR and 30 had type B dissection. Median follow-up was 34 months. Overall, 48% were lost to follow-up, whereas 9% never returned for surveillance after their initial hospitalization. Follow-up was compared for each of the comorbidities and socioeconomic factors; none were found to significantly affect follow-up. The known complication rate was 31% (n = 49), with reintervention performed in 21% of EVAR patients and crossover to intervention in 33% with dissection. All-cause mortality was 20% as determined by the Social Security Death Index. Despite a significant rate of reintervention in patients with EVAR and type B dissection, long-term compliance with surveillance is limited. In addition, predicting who is at risk of being lost to follow-up remains difficult. Coordinated protocols to capture EVAR and type B dissection patients for surveillance studies are needed to ensure optimal follow-up for these patients.