Sonography is a highly accurate method for assessing the abdominal aorta and the iliac arteries for aneurysms and their complications. Proper technique is required, however, to ensure diagnostic accuracy. With respect to abdominal aneurysms, the principal duplex applications are diagnosis, measurement, and follow-up after surgery. Assessment of contained aortic rupture is best accomplished with CT, rather than ultrasound. Aortic dissection may be diagnosed with duplex sonography, but the extent of dissection and the circulatory ramifications are best evaluated arteriographically. This review article considers the pathology of aortic and iliac aneurysm, sonographic techniques for evaluating aneurysms, and manifestations of aneurysm complications. Sonographic assessment of aortic grafts also is considered.