Endovascular stent grafting for aortic aneurysms using metallic stents covered with conventional vascular grafts has attracted attention as a catheter-based, minimally invasive alternative to open surgery. Since the first clinical experience with endovascular stent grafting for an abdominal aortic aneurysm was reported in 1991, experimental and clinical investigations have between undertaken world wide. Although several commercial bifurcated stent grafts for abdominal aortic aneurysms are currently available in Europe and Australia, none of the devices are approved for clinical use in Japan and the USA. Hand-made devices are still used in each institution particularly for thoracic aortic aneurysms. Endovascular stent grafting is feasible for aneurysm repair within limited conditions. However, several unsolved issues remain concerning not only delivery devices which require precise skill in stent-graft deployment, but also concerning patient selection and proper indications. Further investigation is necessary to clarify graft durability, aneurysmal neck enlargement, and the fate of the excluded aneurysm sac for long follow-up periods.