This retrospective analysis quantified ethnic differences in incidence, survival and mortality from abdominal aortic aneurysm in New Zealand from 1996 to 2007. Māori were 8.3 years younger at first admission than European/other ethnicities (non-Māori, non-Pacific, non-Asian). Mortality rates were higher in Māori with a relative risk of 1.30 (95% CI 1.06 to 1.60) for men and 2.66 (95% CI 2.13 to 3.31) for women. One-year cumulative relative survival was significantly lower in Māori than European/other ethnicities for both men (60% vs 73%; p<0.0001)) and women (56% vs 67%; p<0.0001). Māori were also much less likely to have their aneurysm repaired electively (39.6% vs 61.1%; p<0.00001). The authors concluded that these ethnic inequalities provide ‘additional support for screening on equity grounds.’