Objectives: We compared perioperative inflammation, fibrinolysis coagulation disorder in both vascular prosthesis replacement (Group O) and endovascular repair (Group E) in patients with abdominal aortic aneurysm. Methods: Thirty-two patients who an agreement was obtained were included in two years. We divided 32 patients into Group O (16 out of 20) and Group E (6 out of 12), adjusted both more than 45 mm diameter and fusiform. We compared that aneurysmal maximal diameter, patients’ background, a perioperative hematologic test (blood count, biochemistry, fibrinolysis coagulation system, and high-sensitive C-reactive protein level), and the presence or absence of postoperative complications. Results: The maximal diameter, comorbidities between both groups did not have the difference. Group E had a short length of stay. Postoperative complications were one Group O, one Group E. As for the hsCRP level (ng/mL), Group O was higher without a preoperative significant difference in 2POD.The TAT level was higher in Group E, and the PIC level was higher in Group O. Conclusions: Inflammation was higher in Group O, and it remains at 7POD. As for the fibrinolysis showed in Group E much more than Group O, the coagulation was converged in both groups at 7POD.