Preoperative positron emission tomography/computed tomography (PET/CT) was performed in 26 consecutive patients considered fit for aneurysm repair. Besides information on aneurysm wall pathology, PET/CT identified 6 patients with concomitant malignancy. As a result of this coincidental finding, the operation was postponed in 2 patients and cancelled in 1. Although previous studies have shown that PET/CT might affect patient selection based on aneurysm wall inflammation, our preliminary results show a big impact on patient management as a result of the sensitivity of PET/CT for detecting malignancy. Future larger studies are warranted to investigate the effect and cost effectiveness of routine PET/CT in abdominal aortic aneurysm (AAA) patients.