INTRODUCTION: An Inflammatory abdominal aortic aneurysm (IAAA) is an inflammatory condition involving the abdominal aorta, accounting for 4-7 % of all abdominal aortic aneurysms (AAAs). In general, AAA is asymptomatic, but IAAA can have some features, including pain, constitutional symptoms, elevated inflammatory markers, and distinguishes findings on imaging. PRESENTATION OF CASE: This article is about a 65-year-old man with flank pain who was diagnosed incidentally with IAAA and underwent surgery. DISCUSSION: Surgery (open or endovascular) is the mainstay treatment for AAA, but in IAAA, due to the inflammatory process, making a good decision is a challenge. CONCLUSION: In this study open aortic reconstruction was the procedure of choice, and it was done successfully.