Objectives To report our experience of endovascular therapy in patients with a descending thoracic aortic aneurysm and dissection Methods Between May 2001 and May 2010, 22 patients with a descending thoracic aortic disease underwent an endovascular therapy at our institution. Of them, the patients who underwent an endovascular therapy without hybrid procedure were evaluated by medical record and a computed tomography (CT). Results A total of 15 consecutive patients (thoracic aortic aneurysm, TAA : 7 patients, thoracic aortic dissection, TAD : 8 patients, 11 males, mean age 57.5짹16.2 years) were implanted a stent-graft. Surgical exposure of access vessel was necessary in 3 patients. Successful exclusion of the primary entry tears of TAD and the inlets of TAA was achieved in all patients. The post-operative complications were noted in 2 patients (pneumonia and hematoma at puncture site). Two patients died 1 and 9 days after the procedure : one from progression of underlying disease, and the other from aortic rupture. A primary endoleak was noted in 3 patients (type I : 2 patients, type II; 1 patient), none of which required subsequent surgical conversion. Spontaneous resolution of an endoleak was seen in 1 patient. The mean follow-up period was 18.7짹11.7 months (range from 2.3 to 33 months). Secondary intervention was required in 1 TAD patients who need additional stent-graft for increased size of abdominal aorta. Secondary endoleak was found in 1 patients (7.1%) (type Ib; 1). No patient died during the follow-up period. Of patients who have follow-up CT, maximal diameter of aorta decreased in 4 patients. Otherwise, there was no interval change in 5 patients. The cumulative event free survival rates at 30 day, 1 and 2 years were 86.7, 79.4 and 79.4%, respectively, using Kaplan-Meier methods. Conclusions For treatment for aortic aneurysm and dissection of the descending thoracic aorta, endovascular therapy may be a technically feasible and effective treatment modality.