Background: Aortoduodenal fistula is a rare but lifethreatening condition. We present a case of an emergency open repair of an aortoduodenal fistula. Case Presentation: A 58-year-old male presented with massive gastrointestinal bleeding. Diagnostic imaging revealed an aortoduodenal fistula over a previous EVAR stent graft. Emergency open surgery was performed where aortic stump was ligated, EVAR stent was explanted and revascularistaion through Left axillobifemoral bypass. The patient had an uneventful recovery