Presented herein is a clinical care report of a successful hybrid reconstruction (i.e., an open operation and endovascular intervention) for a chronic type III B aortic aneurysm in the setting of the renal and lower-limb arteries malperfusion syndrome. Of obvious interest are the circumstances of the operation performed in a 36-year-old male patient who was subjected to a simultaneous reconstruction of the supra- and inter-renal portion of the aorta and endovascular treatment for lower-limb chronic ischaemia. A detailed description thereof is followed by a brief review of the literature related to appropriate decision-making regarding the scope of the reconstruction in the pathology involved.