Aim Management of aortic vascular graft and endograft infection (VGEI) is complex and associated with high mortality. We aimed to compare the outcomes of VGEI managed conservatively or by explantation, using recently proposed definitions, including ‘cure’ and clinical relapse. Methods Patents with possible VGEI discharged 2011-2023 were identified using ICD-10 codes and database searches. VGEI was diagnosed by Management of Aortic Graft Infection Collaboration criteria. Patents were managed by a multidisciplinary team including infectious diseases. The primary outcome was all-cause mortality (Cox regression model). Secondary outcomes were pre-defined clinical relapse and cure. Results Fifty-eight patients were included, 43 (74%) men, median age 74 (range 36-92). Median follow-up was 3.0 (IQR 4.5) years from presentation, with no loss of follow-up. 43 (74%) grafts were infrarenal, 1 (2%) was juxtarenal, 11 (19%) were descending thoracic, and 3 (5%) were ascending thoracic. 15 (26%) had an enteric fistula. 8 (14%) were completely explanted and 5 (9%) were partially explanted. There were no significant improvements in mortality, relapse, or cure, with explantation. Excluding patients with fistula, pre-defined ‘cure’ was achieved in 9/45 (20%) with conservative management, and 4/9 (31%) with explantation. Explantation was not associated with improved survival in either an unadjusted cox model (HR 0.56, 95% CI 0.194–1.61) or after adjustment for age, COPD, CKD stage ≥3 (HR 0.61, 95% CI 0.21–1.8). In addition, explantation was not associated with cure or clinical relapse. Conclusions In this 22-year series, using pre-defined outcome measures, the outcomes of explantation were not significantly superior to those of conservative management. Some patients were cured with antibiotic therapy alone. No patient with a fistula was cured.