Early graft limb occlusion occurred following an emergent endovascular aneurysm repair of a large abdominal aortic aneurysm. The patient presented with symptoms of intermittent claudication. Mechanical thrombectomy with the Rotarex™ device, followed by deployment of the iliac limb to exclude the thrombus and bilateral balloon-expandable stents in the distal aorta and iliac limbs, resulted in reestablishment of flow to the occluded graft limb. Causes of early graft limb occlusion following EVAR are discussed.