Clinical management of abdominal aortic aneurysm (AAA) disease is based on the maximal aneurysm diameter. Novel markers including vascular inflammation, intraluminal thrombus (ILT) composition and mechanical vessel wall stress have been correlated to AAA risk. Prior studies have typically focused on a single marker. We have developed a comprehensive AAA assessment based on high-resolution black-blood MRI and followed 41 patients for 1.9±0.6 years. Our results showed that both active ILT change and inflammation (identified by USPIO uptake) were strongly associated with AAA growth and/or intervention, and wall stress varied in a sub-group of patients. Such comprehensive assessment may improve AAA patient risk stratification.