Purpose Post-endovascular aortic aneurysm repair (EVAR) surveillance is routinely performed worldwide, however there is no universally accepted protocol. The newly published European Society for Vascular Surgery (ESVS) 2024 Clinical Practice Guidelines (CPG) on the Management of Abdominal Aorto-Iliac Artery Aneurysms have recommended a dramatic reduction in follow-up imaging. The aim of this study was to assess the safety and efficacy of these surveillance recommendations using retrospective data from an aortic referral hospital Methods: This retrospective cohort study included all patients that underwent standard endovascular aortic aneurysm repair (EVAR) between January 1st 2000 and December 31st 2019. Computed Tomography Angiography (CTA) at 30-days were reviewed for ‘failure’ and ‘high risk features’ (defined by the ESVS CPG) by a Vascular Surgeon and Interventional Radiologist. Data were analysed for surveillance compliance; indication and timing of re-intervention; morbidity and aortic and all-cause mortality. Results: 477 patients underwent a standard EVAR between January 1 2000 and December 31 2019. 86% were male, median age for repair was 75.8 years (IQR 70-81) and median AAA diameter of 57mm (IQR 53-64). 64.8% of patients had high risk features on 30-day CTA (52.4% type 2 endoleak, 24.9% iliac diameter >20, 8.6% neck angulation >60). Re-intervention was significantly higher in patients with high risk features, 24% vs. 11.5% (Chi-square 6.712, df=1, Fisher’s Exact Test p-value 0.013). 9 (8.7%) low risk patients required reintervention with a median time to re-intervention of 5 years (IQR 5-7). Aortic mortality was rare (n=5) and only observed in high-risk patients. Conclusion: The ESVS CPG surveillance recommendations appear to be safe for the majority of patients, with very few low risk patients requiring reintervention within 5 years of intervention.