Ascending aortic aneurysms are a rare but life-threatening disease. The commonest cause of aneurysm formation is annuloaortic ectasia. Although most aneurysms are asymptomatic yet they require surgery. 20 patients with ascending aortic aneurysms were operated upon in Kasr El Aini from the years 1998-2001. The total early mortality for all surgical procedures was 16%. A great achievement in the outcome of surgery for ascending aortic aneurysms during the last 4 years occurred as a result of improvement in anaesthetic, perfusion, and surgical techniques.