Anaesthetic requirements for endovascular surgery for aortic, carotid and peripheralvascular disease are reviewed. Peculiarities of the surgery which may impinge onanaesthetic management are discussed together with the pre-operative assessmentissues of particular relevance to patients with generalized vascular diseaseThe detailed anaesthetic management for carotid and aortic endovascular repair isaddressed. The lowered peri-operative stress and general morbidity levels whichoccur with endovascular surgery allow sicker patients with greater risk factors topresent for this type of surgery, thus increasing the challenges facing anaesthetists.