Background Endovascular aortic repair (EVAR) of abdominal aortic aneurysms (AAAs) has been marked as standard practice during the past decades. We aimed to investigate the short- and long-term outcomes of EVAR in patients with AAAs in Isfahan, Iran.Method This cohort study was conducted on 50 patients with AAAs who have undergone EVAR procedure consequently in four different hospitals in Isfahan, Iran, between 2017 to 2020. We followed patients for 1 year and recorded some short-term and long-term outcomes.Results The mean age of participants was 66.6±11.7 years old, in which 88%(n=44) of them were male. Elective EVAR was performed in 88% of patients. Regarding the complications one year after EVAR, endoleak and CIN were occurred in 6%(n=3) and 6%(n=3) of patients, respectively. We also reported the rate of in-hospital mortality and 1-year mortality as 2%(n=1) and 8%(n=4), respectively. Univariate regression analysis revealed no significant difference regarding 1-year mortality in patients who underwent EVAR. There were significant lower rate of ICU admission, vascular complications, and lower level of blood urea nitrogen (BUN) and creatinine (Cr) using spinal anesthesia before EVAR. ConclusionDesirable short- and long-term outcomes as expected, combined with a reduction in hospital length of stay and mortality and one-year mortality allowed EVAR to become the favorable therpauetic strategy for AAAs in Iran especially in high risk patients. Lower rate of vascular complications, ICU length of stay and lower level of BUN and Cr were observed using spinal anesthesia in patients who underwent EVAR in our centers.