Repair of abdominal aortic aneurysms by endovascular means is the preferred method in most patients. Despite its popularity, questions remain about the long-term efficacy and durability. Proximal migration and endoleak are associated with significant morbidity and mortality, and are two of the most important factors in achieving a successful outcome. The technology associated with endovascular grafts continues to evolve rapidly, as does our understanding of ideal deployment techniques. Both can impact the incidence of proximal migration as well as endoleak and must be optimized to achieve ideal clinical outcomes.