Objective: The first combined endovascular and surgical approach for thoracoabdominal aortic aneurysm was performed at our institution in 1998. We report a 10-year experience with a hybrid approach to thoracoabdominal aortic pathology. Methods: Records of all patients undergoing a combined endovascular and surgical approach to thoracoabdominal aortic pathology were reviewed. Presenting symptoms, perioperative morbidity and mortality, sequence (single versus two stages), and late results were