Abstract: Death due to rupture of AAA is usually ensued, especially going into free abdominal cavity. Abdominal pain presented as acute abdomen is preceding of it. How to diagnose and manage is the aim of this paper. From January, 1975 to November, 1991, 29 patients with AAA were admitted to our hospital. Among them, 8 cases presented as such situation. 7 cases were males and one female. Ages ranged from 42 to 76 years old, with a mean of 60 years. Attack of acute abdomen appeared from one hour to ten days. All of them had a huge pulsating mass with a mean of 12×8.8cm, and the diagnosis was confirmed by various imaging procedures. 5 cases with pseudorupture of AAA were operated upon and alived. Three cases truely ruptured into abdominal cavity, duodenal lumen and retroperitoneal space, respectively, and died from hemorrh-egic shock, and sequential organic failure, although one was operated on emergent case. Therefore, if the diameter of AAA is larger than 5 cm or with abdominal pain, it should be persuaded to operate immediatly.