Purpose- Endovascular abdominal aortic aneurysm repair (EVAR) has pioneered the management of abdominal aortic aneurysms (AAA) in the last three decades. Various generation of endografts have been developed since with the most controversial being the endovascular aneurysm sealing system (EVAS) known as Nellix developed by Endologix. Long term data remains scarce as to the outcomes of patients treated by the Nellix endograft. The aim of our study is to assess the outcomes following Nellix endograft implantation in the long term. Methodology- A single centre, retrospective, observational study was performed from December 2013 to December 2016. All patients who underwent an EVAR using the Nellix endograft were included in the study. Primary outcomes were focused on time to device failure and the management post Nellix failure. Secondary outcome was focused at patient survival post intervention following Nellix endograft failure/explantation Results- A total of 38 patients were included in the study. Median age was 79 years old. 21% of the study patients were females. Median time to Nellix endograft failure was 5.5 years. 20 patients (52.6%) developed a Nellix endograft failure. The most common cause of failure was a type 1 endoleak followed by acute rupture of the remnant aortic sac. Out of the 20 patients, 6 patients (30.0%) underwent open surgical explantation following Nellix endograft failure. Only one patient died following open surgical explantation in the perioperative period. All-cause mortality at 1-year, 5-year and 10-years were 94.7%, 83.3% and 83.3%. Conclusion- Long term survival following Nellix endograft implantation appears to be acceptable with good outcomes seen in the cohort who subsequently underwent open surgical explantation. A significant proportion of the patients died of non-aortic related causes and there appears to be a subset of patients who remained asymptomatic and alive despite failure of the Nellix endograft.