Endoleak is a well-recognized complication of endovascular treatment of abdominal aortic aneurysms. Despite over 40 years of open transabdominal aortic aneurysm surgery, only in the last decade has endoleak as a complication of open surgery been described. Endoleak after conventional open surgery was first described by Chan et al in 2000 and remains a rare complication. We describe the first reported case of type II endoleak (back-bleeding inferior mesenteric artery) after open repair of abdominal aortic aneurysm, and its successful management by endovascular coil embolization.