Atherosclerotic abdominal aortic ulcers are uncommon in contrast to those of the thoracic aorta. They present with a variety of symptoms. Computed tomography (CT) scans and magnetic resonance imaging (MRI) are the methods of diagnosis. Treatment is made easier with the use of endovascular techniques, which have less mortality and morbidity than open repair. In this paper, we present three cases of penetrating aortic ulcers presenting with abdominal pain. In two of those cases, the diagnosis was made by MRI and missed by CT scan. We present a review of the literature.