This study aimed at comparison between the different modalities of management of thoracoabdominal aortic aneurysm. Endovascular repair has been introduced in the last few years, it has many indications especially in high risk patient, while open surgical repair is the gold standard for repair of aortic aneurysms with decreased rate of mortality and morbidity using modern techniques. Hybrid treatment avoids the trauma of open surgery and the technical difficulties of the endovascular procedure.