To evaluate the non-contrast MR angiography (MRA) findings of aortic aneurysm status post abdominal endovascular aneurysm repair (EVAR) and to measure the diagnostic performance for the detection of endoleaks (ELs). IRB approval and all patients provided written informed consent. Forty-six patients (mean age, 76.8 years; age range, 53–91 years) underwent both contrast-enhanced abdominal CT angiography (CTA) and non-contrast MRA using a respiratory-triggered two-dimensional single shot balanced turbo-field-echo (b-TFE) sequence within 2 weeks after EVAR. Two observers independently documented the standard measurements on CTA and MRA. The relationship between the prognosis of aneurysm and the signal intensity ratio (SIR) on MRA were quantitatively evaluated. The two experienced study coordinators determined six feasible MRA features for the detection of ELs. Significance and diagnostic performance of these features were statistically examined in advance of following blind reading. Two blinded observers, who were known the results of previous evaluation by study coordinators, assessed MRA images for the detection of ELs.The standard measurements showed strong correlation between CTA and MRA (r = 0.92- 0.99) and perfect agreement between two observers (ICC = 0.97 - 0.99). No significant difference was found between SIR and prognosis of aneurysm. Frequencies in appearance of MRA features including “mottled high intensity” and “creeping high intensity with low band rim” were significant differences between the patients with or without ELs (P = 0.000 – 0.001) as positive findings, and “no signal black spot” and “layered high intensity area” were also significant as negative findings as well (P = 0.003 – 0.031). If one of two positive findings was observed, sensitivity, specificity, and accuracy were 77.3%, 91.7%, and 84.8%, respectively. If one of two negative findings was observed, sensitivity, specificity, and accuracy were 50.0%, 95.5%, and 71.7%, respectively. Sensitivity, specificity, and AUC for the detection of ELs evaluated by the blinded observers were 72.7%, 87.5%, and 0.82. The κ values between coordinators and observers ranged 0.522 to 0.881 which showed moderate to almost perfect agreement.Analysis of the EUROSTAR registry has shown that ELs, migration, and kinking are significantly associated with late rupture1). So the follow-up imaging after EVAR is necessary to identify these complications together with others, such as thrombosis, or sac enlargement2). CTA is the most widely used modality for the observation after EVAR because of its excellent reproducibility and spatial resolution, despite the disadvantages of the associated radiation exposure and the potential for nephrotoxicity3). In several studies, gadolinium-enhanced MRA was at least as sensitive as CTA, and in some cases demonstrated ELs that were not detected at CTA4-6). However, nephrogenic systemic fibrosis has been reported primarily in patients with chronic kidney disease who received gadolinium-based contrast material7-8). Generally the patients with AAA were comparatively late age, so gadolinium-based contrast materials should be avoided in these patients who may require repeated examinations during the pre- and/or post-treatment period. The b-TFE sequences are widely used for vascular assessment because they offer excellent contrast resolution and fast image acquisition without radiation exposure and use of contrast materials9). Previously reported that it is adequate to provide the required anatomical information for preoperative EVAR planning10). In our study, measurements with CTA and non-contrast b-TFE MRA showed excellent inter-modality and -observer agreement despite of the stent-induced susceptibility artifacts. Non-contrast b-TFE MRA also exhibited excellent contrast between the aortic lumen where blood flows, mural thrombus formation mixed with old and new blood clot, and aortic walls consisted of smooth muscles and collagenous fibers, resulting in accurate measurements. We confirmed that non-contrast b-TFE MRA can accurately identify the sac enlargement and thrombosis. In addition, appearance of four MR features demonstrated the feasible diagnostic performance for the detection of ELs. We believe that non-contrast MRA is the reliable modality for the patients status post EVAR who requires repeated follow-up examinations. It is also fact that non-contrast b-TFE is inferior to contrast-enhanced CTA or MRA for the visualization of peripheral vessels or micro-structure11). Contrast-enhanced CTA or MRA should be considered for detecting the culprit vessel of ELs in suspected cases based on evaluation of non-contrast MRA.Non-contrast MRA can appear to be a useful modality for the patient follow-up status post EVAR.