This review aims to evaluate diagnostic performance of dual-energy computed tomography (DECT) in follow-up examinations after endovascular aneurysm repair (EVAR) and its radiation dose estimates compared to the standard triphasic protocol. A systematic search was conducted on 20th May 2018 on the following databases: MEDLINE, PubMed, and Scopus. Articles were screened against the inclusion and exclusion criteria. A narrative review of the literature was performed. A summary statistic table of the calculated mean effective dose (ED), percentages in dose reduction and diagnostic performance of DECT were pooled. Five original articles were included. Compared to the triphasic protocol being the reference standard, data from the DECT acquisitions were observed to have 98–100% overall accuracy for the detection of type I and II endoleaks. The cumulative EDs were significantly different (p<0.001) between the protocols. The ED delivered in the DECT protocol was approximately 61% lower than that delivered to the patient by the standard triphasic protocol (11.1 mSv compared with 27.8 mSv). A DECT protocol can replace the standard triphasic protocol in follow-up imaging after EVAR for the detection of type I and II endoleaks. This acquisition protocol also significantly reduces the ED to the patients.