Small bowel infarction following abdominal aortic reconstruction is extremely rare, and the prognosis remains poor. This report describes a 65-year-old man with small bowel infarction after resection of an abdominal aortic aneurysm. He was successfully treated with resection of the ischemic segment from the distal duodenum to the mid-small bowel and construction of a duodenoileostomy. The postoperative course was uneventful.