Ionizing radiation exposure is an inherent component of endovascular surgery. As procedures become more complex, greater radiation exposure is incurred by both staff and patient. Radiation doses during endovascular aneurysm repair are similar to those recorded during percutaneous coronary interventions. Ionizing radiation may cause skin injury, as well as increase the long-term risk of malignancy. Endovascular surgeons need to be aware of radiation hazards and take all reasonable steps to minimize the risks to both patients and staff.