Purpose Endovascular Aneurysm Repair (EVAR) is now the most common technique for Abdominal Aortic Aneurysm (AAA) repair. This study seeks to investigate demographic, technical and outcome differences between elective and ruptured AAA treated with EVAR in Australia and New Zealand. Methodology Data was collected from the Australian Vascular Audit for all patients undergoing an EVAR for aortic aneurysm repair between 2011 – 2021. Demographic, technical and outcome data was collected and patients were stratified by the indication for operation. Operations for false, mycotic and occluded aneurysms were excluded. Results The mortality rate for ruptured EVAR was markedly higher at 13.9% (95%CI 11.5-16.3%) compared to 1.4% in the elective cohort (95%CI 0.6-1.6%). There was a significant difference in aneurysm size with an average diameter of 7.1cm in the EVAR group (95%CI 6.96-7.24%), compared to 5.7cm in the elective group (95%CI 57.4-57.7%). There was a significant difference in frequency of suprarenal fixation use, with 89% in ruptured EVARs (95%CI 86.6-91.4%) compared to 84.6% in the elective cohort (95%CI 86.6-91.4%). Patients undertaking an elective EVAR demonstrated a lower prevalence of renal failure (Cr>150), 7.2% (95%CI 6.8-7.6%) compared to those with ruptured aneurysms 17.2%, (95%CI 14.5-19.8%). Conclusion EVAR is a well-established technique for the treatment of both elective and ruptured AAA. This study found a difference in use of suprarenal aortic fixation between elective and ruptured aneurysm patients treated with EVAR. This may be driven by clinician preference, device familiarity, or perceived technical advantage, however the uncertain impact upon patient outcomes of this difference warrants further research.