The aim of the study was to evaluate the possibility of reducing the blood loss during elective surgery for abdominal aortic aneurysms using particular intraoperative surgical expedients. From 1993 to 1999, 200 patients were recruited into the study. We performed 90 aorto-aortic, 84 aorto-bisiliac, 4 aorto-iliac-femoral, 12 aorto-bisiliac-hypogastric, and 10 aorto-bifemoral reconstructions. Several surgical techniques were used and are described in detail. The mortality rate was 3.5%. Haemoglobinaemia 24 hours after the operation had decreased by 2.5 +/- 0.9 g/dl. In 67% of cases the estimated blood loss was lower than 300 ml. There were no transfusions in 44% of cases, and autologous transfusions in 17%. The average estimated blood loss was 350 ml, with mean reinfusion of 0.98 blood units. Our study suggests the possibility (44%) of avoiding the use of blood transfusions thanks to intraoperative blood saving by means of particular surgical techniques.