Purpose In Australia, peripheral artery disease affects over 20% of the population aged 75 and over, and the prevalence of abdominal aortic aneurysm has remained at 4-6% over the last 20 years. Despite this prevalence of occlusive and aneurysmal disease, rates of open aortic surgery have been decreasing. This could be driven by risk factor modification such as smoking cessation, greater control of hypertension and hypercholesterolaemia, and a shift towards an endovascular-preferred approach. This study investigates this decreasing trend and its direct impact on vascular surgery trainees. Methodology Medicare Benefits Schedule item numbers for open and endovascular interventions for occlusive and aneurysmal disease were identified. Aggregated data was obtained from the Services Australia Medicare website between 2000 and 2025. Results were tested for statistical significance, and trainee data was extracted from the Australian and New Zealand Society for Vascular Surgery. Results Total abdominal aortic open operations across Australia decreased from 152 in 2000 to 45 in 2025 (p<0.0001). Negative binomial regression identified an average yearly decline of 4%. Endovascular aneurysm repairs and aortoiliac stents showed a statistically significant increase over 25 years. These findings were corroborated by data within the Australasian Vascular Audit (AVA). With 45 open operations and 52 trainees in 2025, this represents 0.86 cases per trainee per year. This limited case number, compounded by an uneven distribution of cases among hospitals, results in minimal exposure for trainees and has potential implications for trainee proficiency in open aortic surgery. Conclusion This study highlights the significant decrease in open abdominal aortic operations across Australia and its impact on vascular surgery trainees. Further research into this can contribute to a better understanding of these challenges and guide future improvements to vascular surgery training.