Background: Takayasu���s arteritis (TA) is a primary vasculitis resulting in stenosis or aneurysmal change of involved vessels. Some TA patients need revascularization to control ischemic symptoms, renovascular hypertension, or aneurysmal lesions. However, there has been lack of evidence about the optimal revascularization method between endovascular treatment and surgical therapy in TA patients. Methods: From September, 1994 to January, 2011, 235 patients were diagnosed with TA according to the diagnostic criteria of 1990 American College of Rheumatology. Among them, total 65 (27.7%) patients underwent revascularization. Symptomatic recurrence and angiographic recurrence were reviewed retrospectively. Perioperative use of immunosuppressive drugs was analyzed. Results: In 65 TA patients, Total 111 procedures were performed during the follow-up periods (median follow-up duration 2.4 years, range 0.1-152 months). During 2 years of follow-up, the symptomatic recurrence rate was significantly higher in endovascular treatment group (32.3% vs 11.5%, p=0.016). The incidence of angiographically-significant stenosis was also higher in endovascular treatment group (32.1% vs 11.1%, p=0.026). However, the symptomatic recurrence rate was not different according to use of perioperative immunosuppressives (20% vs 34.1%, p=0.34). Conclusions: In TA patients, surgical revascularization appears superior in patency compared to endovascular treatment. When the appropriate immunosuppressive treatment was applied during perioperative period, disease activity of TA seems not to influence patency of revascularization.