Bacterial aortitis is a rare, but fatal, infectious disease underlying an atherosclerotic aorta or normal aortic wall in an immunocompromised host. The commonly identified organisms responsible for the condition are Salmonella, Staphylococcus and Streptococcus, and on rare occasions, E.coli. We report a case of a 57-year-old man with bacterial aortitis and a splenic abscess caused by E.coli, which was successfully treated by periaortic debridement, prosthetic graft replacement, splenectomy and antibiotic therapy.