Purpose: Small bowel obstruction (SBO) secondary to adhesions or incisional hernias is a well-recognized complication of open abdominal operations. Despite this, the rate of SBO after open abdominal aortic aneurysm repair (OAR) remains poorly studied. The accurate description of complications following OAR is increasingly important to help counsel patients making a choice between open or endovascular repair of their abdominal aortic aneurism. This study aims to identify the long-term rate of SBO in patients undergoing OAR. Methodology: All patients who underwent an OAR at Auckland City Hospital between January 2004 and December 2008 were identified. Exclusion criteria included mortality within 30 days, overseas residency, and incomplete medical records. Electronic medical records were retrospectively reviewed to identify patients who developed SBO after OAR, along with the aetiology and management. Results: Two-hundred and twenty-six patients were included in our study. Most patients were male (75.7%) and of European ethnicity (85.0%). At the time of analysis, two-hundred and five (90.7%) patients were deceased. The median follow-up for survivors was 18.2 years (Mean: 17.80 +/- 1.40 years). Ten patients (4.4%) developed a SBO after OAR. Two episodes of SBO were due to incisional hernias, eight were due to adhesions. Amongst the eight patients who developed adhesional SBO only three had a virgin abdomen prior to OAR. Six patients (2.6%) required surgery to manage the SBO. Conclusion: The long-term rate of SBO amongst our OAR patient cohort is significantly lower than that described following other open abdominal operations. The majority of SBOs in our cohort were due to adhesions that may have been caused by processes preceding the OAR. SBO remains a rare complication of OAR to discuss with patients considering open surgery for abdominal aortic aneurisms.