Purpose Ruptured abdominal aortic aneurysm (rAAA) is a time-critical emergency with reported mortality of 30-50%. In June 2019, Northern Health introduced a hospital-wide “Code AAA” protocol to expedite activation, CT imaging, resuscitation and transfer to theatre. We evaluated its impact on process metrics, perioperative morbidity and mortality. Methods Single-centre retrospective cohort study of consecutive patients undergoing emergent repair of rAAA following emergency department presentation. Included patients were stratified by presentation before (Jan 2010 - Jun 2019; n=27) or after (Jun 2019 - May 2026; n=16) protocol implementation. Baseline characteristics, process and operative metrics, and outcome data were extracted and comparative analyses were performed. Results Baseline characteristics were comparable, though the post cohort was older (pre-protocol median age 75 years, post 82.5 years). EVAR use rose markedly (15% pre vs. 75% post, p<0.001). Median triage-to-theatre time trended shorter (251 minutes pre vs. 179 minutes post, p=0.16), and 30-day mortality was similar across the cohorts (pre 41%; n=11/27 vs. post 44%; n=7/16, p=1.0). The post-protocol cohort received significantly less blood product, both intraoperatively (pre-protocol median 4 units vs. post 2 units, p=0.022) and in total (7 pre vs. 4 post, p =0.029). Following the implementation of the protocol, median inpatient stay was lower at 6 days, compared with 8 days prior to implementation (p=0.25). Conclusion: Following implementation of the Code AAA protocol, we observed a non-significant trend towards expedited operating theatre transfer, reduced blood product use and shorter inpatient stay in the emergent management of ruptured AAA. While a shift toward endovascular repair was noted over the same period, this was observational. These findings support the value of coordinated, protocolised pathways for time-critical vascular emergencies and warrant confirmation in larger, multi-centre cohorts.