INTRODUCTION: EVAR surveillance at the Royal Adelaide Hospital is traditionally performed with arterial duplex ultrasound (ADUS) with the possible addition of computed tomography angiography and /or digital subtraction angiography for further interrogation. We have added CEUS into the algorithm over the last three years. This study aims to evaluate our process and early results. METHODS: The process of commencing a new CEUS service will be reviewed. EVAR patients at our institution undergo ADUS for monitoring of graft patency and endoleak detection as the first line investigation, at 6 weeks, 6 months and annually post-EVAR. CEUS is performed when an endoleak is suspected on preceding imaging but ill defined. CEUS was performed with endoleak documentation at each stage. The results were further reviewed by a consultant vascular sonologist for consistency and validation. RESULTS: Data from CEUS from June 2022 to August 2025 was enrolled into the study with institutional ethics approval. 45 ADUS and CEUS studies were performed and evaluated. There were 17 cases in which ADUS identified an endoleak, but not type, with CEUS providing clarity in 16/17 (94%) of cases. CEUS enabled avoidance of further contrast administration in patients with either no endoleak, or type 2 endoleak; 11/17 (65%) of cases. CEUS was able to identify that 8/12 cases where ADUS concluded there was no endoleak, that were in fact type 2 endoleaks. CONCLUSIONS: For endoleaks which are inconclusive with ADUS, the introduction of a CEUS service was able to provide clarity in 94% of cases in our small series, with the majority of these not requiring any further imaging such as CTA, avoiding radiation dose and risk of kidney injury.