We report a case of an elderly man admitted with abdominal pain and fever, 5 months after endovascular aortic aneurysm repair of a suspected inflammatory abdominal aortic aneurysm. He underwent successful explantation of an infected stent graft with suprarenal fixation following extra-anatomic revascularization. After a prolonged hospitalization, he was discharged on antibiotics and at follow-up has returned to baseline activity level. Although explantation of an infected prosthesis following endovascular aortic aneurysm repair has been previously reported, our case prompted a review of the literature to evaluate mode of presentation, putative factors, and management decisions associated with reduced morbidity and mortality.