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To investigate the effects of exercise training on ventilatory efficiency and physiological responses to submaximal exercise in subjects with small abdominal aortic aneurysm (AAA).Sixty-five male patients (72.3 ± 7.0 years) were randomized to exercise training (n = 33) or usual care group (n = 32). Exercise subjects participated in a training groups for 3 mo. Cardiopulmonary exercise testing was performed before and after the study period and peak O2, the ventilatory threshold (VT), the oxygen uptake efficiency slope (OUES), and the E2/CO2 slope were identified. Baseline work rates at VT were matched to examine cardiopulmonary responses after training.Significant interactions indicating improvements before and after training in the exercise group were noted for time (P < .01), O2 (P < .01), and work rate (P < .01) at the VT. At peak effort, significant interactions were noted for time (P < .01) and work rate (P < .01), while borderline significance was noted for absolute (P = .07) and relative (P = .04) O2. Significant interactions were observed for the OUES both when using all exercise data (P = .04) and when calculated up to the VT (P < .01). For the E2/CO2 slope, significance was noted only when calculated up to the VT (P = .04). After training, heart rate, E, O2 and respiratory exchange ratio were significantly attenuated for the same baseline work rate only in the exercise group (all P < .01).Exercise training improves ventilatory efficiency in patients with small AAA. In addition, patients who exercised exhibited less demanding cardiorespiratory responses to submaximal effort.