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Background: Emergency Abdominal Aortic Aneurysm (AAA) treatment requires either an open surgical repair or a closed endovascular (EVAR) surgical repair. Compared to an open repair, closed repairs are less-invasive technique, and data is emerging regarding which surgical approach leads to better long-term morbidity and mortality rates. This research compares and analyzes data for long-term morbidity and mortality rates as well as re-intervention rates following treatment by open repair or endovascular repair. Objective: To answer the research question, "Does open abdominal surgery or endovascular technique lead to higher long-term success rates regarding morbidity and mortality in patients requiring surgical repair of an impending or already ruptured AAA? Methods: The evidence-based medicine-systematic review (EBM-SR) was performed with both an independent and a duplicate search and review of three databases: South College Library Discover Search, PubMed, and Google Scholar. Limits were individualized for each database and inclusion and exclusion criteria was applied. A reputable data extraction tool, Covidence, was utilized, as well as the National Institute of Health (NIH) quality assessment tool. Three studies were selected for qualitative analysis. These studies included one systematic review and meta-analysis, one meta-analysis, and one retrospective cohort study. Results: Two out of the three studies determined that long-term morbidity and mortality rates are statistically comparable between the two surgical approaches, with all three studies indicating that an endovascular approach leads to higher rates of long-term reintervention. Conclusion: Long-term success rates are similar regardless of method of surgical intervention. However, due to the continuing advancements emerging in endovascular surgical technology, further research and data is needed to determine whether open or closed AAA repair OPEN VS. CLOSED AAA REPAIR v provides better long-term morbidity and mortality rates, given the higher incidence of reintervention for EVAR.