Purpose: To evaluate the effect of radiation dose reduction with the Allura ClarityIQ image processing technology for fixed C-arms in comparison with a mobile C-arm and an Allura fixed C-arm without ClarityIQ technology during endovascular aneurysm repair (EVAR) procedures. Methods: Radiation dose data from 85 patients (mean age 74.2±7.8 years; 68 men) undergoing EVAR with mobile and fixed C-arm fluoroscopy were retrospectively analyzed. The radiation dose parameters included the kerma area product (KAP), fluoroscopic time (FT), and number of digital subtraction angiography (DSA) frames (Fr_DSA). KAP_total consisted of KAP_fluoro (KAP for fluoroscopic imaging) and KAP_DSA (KAP for DSA and single shots). Linear regression analysis was used to explore differences in the association of KAP with the FT, Fr_DSA, and body mass index (BMI) among the 3 C-arms. Results: The mean KAP_total values for mobile, Allura C-arm, and AlluraClarity C-arm for noncomplex EVARs were 56±39, 245±142, and 157±120 Gy·cm² (p<0.001); for complex EVARs, the values were 110±43, 874±653, and 598±319 Gy·cm² (p<0.001), respectively. On average, KAP_fluoro tripled when the mobile C-arm was replaced by the fixed C-arm. There were no significant differences in the KAP_fluoro adjusted for the FT between Allura and AlluraClarity (p=0.69). However, there was a major 61% reduction in KAP_DSA from 1.36 Gy·cm² per DSA frame for Allura to 0.54 Gy·cm² per DSA frame with AlluraClarity (p=0.03). For the mobile C-arm, BMI was not associated with KAP (p=0.13). The associations of BMI with KAP_fluoro and KAP_DSA were significant for both fixed C-arms but were more robust for Allura compared to AlluraClarity (p=0.02 for KAP_fluoro and p<0.001 for KAP_DSA). Conclusion: Changing a mobile C-arm for a fixed C-arm in a hybrid operating suite increased the average intraoperative dose during EVAR. Upgrading the Allura fixed C-arm with ClarityIQ technology resulted in a 61% reduction in the radiation per DSA frame.