Abdominal Aortic Aneurysm (AAA) represents a significant global health issue with a high risk of rupture, resulting in substantial mortality rates. Endovascular Aneurysm Repair (EVAR) has emerged as the preferred treatment method due to its minimally invasive nature. However, the procedure carries a risk of acute kidney injury (AKI), particularly post-contrast acute kidney injury (PC-AKI), which can adversely affect patient outcomes. This review examines the incidence, pathophysiology, and prevention strategies for PC-AKI in the context of EVAR. It synthesizes current research on the mechanisms underlying PC-AKI, such as renal vasoconstriction, oxidative stress, and tubular toxicity. The effectiveness of various preventive measures, including pre-procedural hydration, use of low-osmolality contrast agents, and alternative imaging techniques, is evaluated. Additionally, the review explores patient-specific risk factors and the potential of novel pharmacologic interventions. The incidence of PC-AKI in EVAR varies based on procedural complexity and patient-specific factors like preexisting renal insufficiency, diabetes, and hypertension. Preventive strategies such as intravenous hydration and the use of less nephrotoxic contrast agents have shown effectiveness. Advances in imaging technology and innovative pharmacologic interventions, including antioxidants and vasodilatory drugs, present promising approaches to reducing the risk of PC-AKI. Effective management of PC-AKI in EVAR necessitates a comprehensive and multifaceted approach that considers both procedural and patient-specific factors. Future research should aim to standardize diagnostic criteria, refine preventive strategies, and explore novel therapies. Enhanced understanding of PC-AKI pathophysiology and personalized preventive measures can improve patient safety and outcomes in EVAR procedures.