Aortobiiliac stent graft repair was performed in a patient with a 5.9 cm infrarenal abdominal aortic aneurysm. Patient had a left iliac covered stent, and a crossover femoral–femoral graft performed 4 years previously for right common iliac and external iliac artery occlusion and a left common iliac artery stenosis. The patient was found to have a left femoral anastomotic aneurysm at the site of the anastomosis of the crossover graft to the left common femoral artery. The delivery of the endograft through the left iliac artery/stent was challenging. Completion aortogram showed encroachment of the fabric of the endograft into the origin of the left renal artery. Two months later, the left renal artery was found to be occluded. The patient had earlier refused left renal stenting for the management of encroachment of the endograft into the left renal artery. The patient died 8 months later from respiratory failure.