Background: The treatment of iliac artery aneurysms (IAA’s) has been revolutionised by iliac branch devices (IBD’s), which reduce the incidence of buttock claudication, pelvic ischaemia and erectile dysfunction. Whilst traditional technique has been to utilise the infrarenal aorta (even if not aneurysmal) as the proximal sealing zone and to sacrifice one internal iliac artery in the case of bilateral IAA repair, bilateral IBD’s can be deployed without the aortic component via bilateral femoral percutaneous access. The authors present a case series with up to 10 year follow-up. Methods: This was a prospective cohort study of 3 patients with isolated bilateral IAA’s, who underwent endovascular repair using bilateral IBD’s and without aortic stent graft extension in a tertiary hospital. Annual imaging was performed with duplex scan and computed tomography to assess stent graft patency, endoleak, sac size and aortic diameter growth over a 10-year period. Results: Procedural success was 100% with 0% perioperative mortality. 1 (33%) patient required additional common iliac stenting on the first post-operative day. Over the 10-year period, graft patency was 100% with 0% endoleak and 0% requiring surgical intervention of the aorta. Conclusion: This study documents the long-term success of bilateral IBD’s without aortic stent graft extension performed via bilateral femoral percutaneous access in the setting of isolated bilateral IAA’s. Proximal seal can be achieved in the common iliac arteries, and the aorta, if not aneurysmal at the time, may not require subsequent surgical intervention. This has the potential advantage of reducing aortic occlusion rates and the elimination of collateral arterial supply for spinal cord perfusion. Keywords: iliac artery aneurysm, iliac branch device, bilateral iliac artery aneurysm, endovascular repair