Purpose: The growth patterns of small abdominal aortic aneurysms (AAA) have been the subject of several randomised trials and summarised by level 1 analyses. However, there has been a change in the epidemiology of the AAA population, specifically a reduction in smoking rates, older age at presentation, and better cardiovascular risk management, which might affect AAA growth (1). Furthermore, AAA growth data in the Māori population has not been previously reported. The hypothesis of this study was that the background epidemiological changes and improvements in medical management slow the growth of small AAA. Methods: Retrospective analysis of all patients with a small AAA who were undergoing longitudinal ultrasound surveillance in a tertiary vascular centre. The data were sourced from the Waikato Hospital Vascular Surgery database. There were 5153 scans included, with an average of 4.8 scans per person. Results: 1071 patients were enrolled in the small AAA ultrasound surveillance program, of whom 801 had >1 scan and were included in the analysis. 207 patients underwent AAA repair, and 358 patients died without repair. The median (range) age at the time of the first scan was 74 (45-97). The overall mean growth rate was 2.15mm/year and the median growth rate was 1.7mm/year. There were 224 (28%) women and 83 patients identified as NZ Māori. The median growth rate for men was 1.76mm/year and for women 2.28mm/year. The median growth for Māori men was 1.82mm/year and for Māori women 2.63mm/year. Conclusions: Growth of AAA in contemporary patients appears slower than that reported previously. Growth rates in women were higher, with the fastest growth occurring amongst Māori women, which requires further attention to reduce this disparity. References: 1. Prendes CF, Gouveia e Melo R, Caldeira D, D’Oria M, Tsilimparis N, Koelemay M, et al. Systematic Review and Meta-Analysis of Contemporary Abdominal Aortic Aneurysm Growth Rates. Eur J Vasc Endovasc Surg. 2024;67(1):132-45.