Acute aortic thrombosis which develops in the long-term following an endovascular aneurysm repair is rare. A 78-year-old male patient presented with rest pain and sudden-onset coldness at lower limbs for four hours. His medical history revealed an endovascular aneurysm repair for an infrarenal abdominal aortic aneurysm two years ago. He was diagnosed with acute ischemia at lower limbs due to acute thrombosis of the infrarenal aorta. We first performed an axillobifemoral bypass surgery for limb salvage. Due to recurrent thromboses of the left limb of the graft during long-term follow-up, we applied aortobifemoral bypass procedure to provide adequate lower limb flow.