Thoracic aortic aneurysms in elderly patients are being recognized with increasing frequency. A review of 12 patients 70 years of age or older who underwent repair of aneurysms of the descending thoracic aorta without the use of shunts or bypass revealed that this operation could be performed with acceptable morbidity and mortality. The two deaths in this series were patients who were operated on emergently, whereas all patients operated on electively or urgently survived to leave the hospital.