To assess the long-term results of elective abdominal aortic aneurysm (AAA) repair with a single stent graft system. Patients undergoing elective, infrarenal endovascular aneurysm repair (EVAR) with a single-stent graft system between 1998 and 2012 were analyzed retrospectively registering pre-, intra-, and postoperative data. All imaging was reviewed. Data are presented as median and interquartile range unless otherwise stated. Primary and secondary clinical success rates were 58 ± 3% and 78 ± 2% at 10 years, respectively. Freedom from late AAA-related death was 96 ± 1% and overall survival was 32 ± 2% at 10 years. Late persistent secondary clinical failure occurred in 77 (14.2%) patients. Elective infrarenal EVAR of asymptomatic AAA with single-stent graft has sustainable long-term results, especially when the aneurysm neck anatomy is favorable. AAA-related death and conversion to open repair are very rare events, but the overall survival after 10 years is quite low. The majority of the patients with persistent failure were unfit or refused further reinterventions or had stable findings. Good patient selection and technical developments may continue to improve the results in the future.