Graft replacement remains the procedure of choice for patients with thoracoabdominal aortic aneurysm. Since there is little information regarding the long-term survival following these major vascular operations which may carry a risk of various late complications, a retrospective analysis of 10 years follow-up was undertaken. The results of 172 consecutive operations for thoracoabdominal aortic aneurysm were analysed retrospectively. Hospital mortality rate was 10.5%. Temporary postoperative haemodialysis was necessary in 10.4% of cases and paraplegia occurred in 8.2%. The mean (s.e.) overall cumulative 2-, 5- and 10-year observed survival rate was 76(3.4), 53(4.5) and 19(7)%, respectively while expected survival of a background population at 2, 5 and 10 years was 94%, 85% and 71%, respectively. Reoperation for an early (< 7 days) or late (> 7 days) aortic event was necessary in 31 patients. If performed electively, the hospital mortality rate for late aortic reoperation was only 7% but an emergency reoperation, hospital mortality rate was 100%.