Purpose: Numerous studies have demonstrated acceptable outcomes in octogenarians and nonagenarians undergoing operative intervention for abdominal aortic aneurysm (AAA). Emerging research, however, has started to question the value of ongoing surveillance in this cohort. Studies estimate that only 8.3% of patients aged >80 years reach the threshold for intervention and of those that reach threshold only 2% are fit enough for treatment. This question is increasingly relevant as the population ages and the prevalence of AAA in the elderly continues to rise, placing strain on resource limited surveillance programmes. The aim of this study was to identify early predictors of futile surveillance in elderly patients enrolled in AAA surveillance programmes. Method: Data were retrospectively collected for all patients aged >80 years enrolled in our regional AAA surveillance programme between 2012-2022. Demographics included comorbidity and frailty data, using the Charlston Comorbidity Index (CCI), the Clinical Frailty Scale (CFS) and the 5-item modified frailty index. Data pertaining to initial aneurysm size and subsequent growth rate were collected. Outcome data included, threshold reached (using standard guidelines, 5.5cm for males and 5.0cm for females) and intervention offered. Univariate and multivariate analyses were conducted to determine factors correlating to futile surveillance. Results: Over one third of patients in the AAA surveillance program were aged >80 years. Preliminary data suggest that the small number of patients that reach threshold are severely comorbid with patients progressing to anaesethic assessment having a CCI>5. The majority of patients that came forward for repair had a CFS of 3 (managing well). The decision not to proceed with intervention was both patient and clinical driven. Conclusion Ongoing research is required. Preliminary results suggest that patients that reach threshold are severely comorbid, while those that proceed to intervention are less frail.