We present the case of a 51-year-old Japanese man with immunoglobulin G4-related inflammatory abdominal aortic aneurysm (AAA). A computed tomography scan showed a 60-mm AAA with inflammatory aortic wall thickening and bilateral hydronephrosis. We did not administer steroid therapy but undertook endovascular aneurysm repair. Postoperatively, inflammation of the aorta and hydronephrosis ameliorated without steroid therapy. The treatment of immunoglobulin G4-related inflammatory AAA is still debated. We achieved good clinical results with endovascular repair alone. Keywords: EVAR, IgG4-related IAAA, Hydronephrosis, Steroid
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