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Endoleaks continue to be a challenge in the endovascular approach to aneurysm repair, both in the abdominal and thoracic aorta. Some of these leaks are related to anatomic factors and patient selection, others are device related, and some (especially type II leaks) appear intrinsic to the endovascular approach. Certain endoleaks require treatment as soon as they are detected due to continued pressurization of the aneurysm sac, while the need for treatment of others remains controversial. Using endovascular techniques, the vast majority of these problems can be successfully addressed without the need for open surgery. This paper reviews our 14 year experience in the management of endoleaks and summarizes our current approach to these patients.