Management of thoracoabdominal aortic aneurysm is a challenging task as it involves replacement of the aorta in those areas where major arterial branches supply vital organs.Because of the risk of rupture, all patients with TAAA greater than 6 cm in diameter, are considered for surgical or endovascular repair.Different Surgical techniques are used for repair of TAAA, the Clamp and Sew technique emphasizes the principles of operative expediency and simplicity, whereas in patients at greatest risk for development of postoperative paraplegia Distal Aortic Perfusion technique is advised, while for patients presented with extensive TAAA, a staged repair by Elephant-Trunk technique is used.