Introduction: Days Alive and Out of Hospital within 90 days of surgery (DAOH90) is a composite outcome that integrates death, hospital length-of-stay and hospital readmissions. The aim of this study is to investigate postoperative mortality, DAOH90, and ‘failure to rescue’ (FTR) following abdominal aortic (AAA) surgery across AoNZ. Methods: Population-based retrospective cohort study of all AAA interventions performed in AoNZ between 2010 and 2024, identified from National Minimum Dataset. Patients categorised using ACHI procedure codes: non-ruptured open repair, ruptured open repair, and endovascular repair. Outcomes included 90-day mortality, post-operative complications, FTR and DAOH90. National procedural coding data identified AAA intervention in public hospitals between January 2010 and December 2024. Results: 6,978 patients had aortic repair across nine hospitals, of whom 2,721 had open repair, 4,257 endovascular intervention. Overall 90-day mortality was 6.7% non-ruptured open repair, 35.7% ruptured open repair, and 3.9% endovascular intervention. There was marked inter-hospital variation in 90-day mortality in both intact open (OR 2.0, 1.3-3.0) and endovascular repair (OR 10.4, 2.6-42.2). Differences in post-operative complication rates were less pronounced in both intact open (OR 1.1; 0.9-1.3) and endovascular (OR 1.7; 1.3-2.2), however, this re-appeared when comparing post-operative mortality following a complication for both intact open (OR 2.1, 1.4-3.3) and endovascular intervention (OR 7.9, 1.9-32.6), suggesting hospital variation in mortality was primarily driven by differences in ‘rescue’ from complications (Spearman correlation coefficient = 0.82), rather than complication incidence (correlation coefficient = 0.45). Conclusion: Variation in outcomes after aortic surgery in AoNZ is driven by hospitals’ capacity to rescue, rather than frequency of complications, suggesting the importance of postoperative monitoring and critical care access.