Endovascular repair of popliteal artery aneurysms has been used with increasing frequency in recent years. Advocates of the procedure claim a lower rate of complications, early return to work, no change in the quality of life, and long-term patency rates that are as favorable as those following open surgical repair. Unfortunately, data of only 1 prospective randomized study are available, and a recent meta-analysis showed a higher rate of early graft thromboses and more early reinterventions after endograft repair of popliteal artery aneurysms. Open, elective surgical repair with the vein graft has patency rates more than 90% in contemporary series. Current evidence only supports the use of stent grafts in those with high surgical risks and in the elderly.