Aim: The aim of this study was to evaluate the outcome of unselected, real-world patients with ‘‘off-label’’ proximal necks treated with endovascular repair (EVAR). Patients and Methods: This is a retrospective study of 9 patients with AAA who underwent endovascular repair over a period of 18 months from January 2013 and were followed up for one year. All patients had an aortic neck that had challenging anatomy either short (less than 10 mm) (n=4) or severely angulated (more than 60°) (n=5). None of them had more than 50% of the neck circumference lined by mural thrombus. None of the patients had a conical neck. The follow-up protocol included physical examination, duplex-ultrasound scan (DUS), and CT at 30 days. Results: During the study period, 9 patients underwent standard EVAR. They were 7 men and 2 women with an age range of 56 to 74 with a mean of 65 years. All of them had one or more comorbidities such as: Diabetes (n=3), hypertension (n=5), coronary artery disease (CAD)(n=4), COPD (n=2) and previous laparotomy (n=1). The device that was used is the Endurant II® (Medtronic, Santa Rosa, CA, USA). Immediate technical success was achieved in all cases. One patient had meutc afcem aumr uaym etuca and one had temporary camr afsyuaetuca within 30 days. At 1-year follow-up, 1 patient suffered a type Ia endoleak which required a proximal aortic extension, and 1 had an acute iliac limb occlusion, treated by surgical thromboembolectomy. Conclusion: This study presents some limitations; it is a non-randomized retrospective study with a small number of patients. Also, a longer follow-up would be needed to confirm the durability of EVAR in patients with hostile aortic necks. We do confirm the notion that this minimally invasive procedure can be performed safely and effectively in patients with challenging neck anatomy. Keywords: EVAR, AAA, endoleak.