A number of studies have shown that aorto-uni-iliac (AUI) endovascular devices coupled with occlusion of contralateral iliac artery and crossover femoral-femoral or iliac-femoral bypass have comparable outcomes in selected patients to treatment with bifurcated devices. However, surgeons debate the disadvantages of the method. Altogether there are at least 12 indications for this procedure. There are potential negative implications related to the open surgical part of the operation. This procedure can be complicated by the development of local complications. AUI endovascular aortic aneurysm repair requires less preoperative planning, less operative time, and less trauma especially for high-risk patients with abdominal aortic aneurysms. AUI with femoral-femoral crossover graft is a safe, effective option with satisfactory midterm results. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2024.