Thoracic aortic aneurysms (TAA) are the most common pathology of the thoracic aorta. TAA are occuring with increasing incidence (10.4 cases per 100,000 person years) and are most commonly caused by atherosclerosis. There are also hereditary, inflammatory and infectious pathogenic factors. A TAA initially causes no symptoms and is therefore usually diagnosed as an incidental finding. Computed tomography angiography (CTA) and magnetic resonance angiography (MRA) are the diagnostic tools of choice for diagnosis and treatment planning. The mean growth rate of TAA is estimated to be 0.10 to 0.42 cm per year. A diameter of 6 cm is considered to be an indication for surgery. Besides medicinal therapy, thoracic endovascular aortic repair (TEVAR) nowadays offers certain advantages compared to conventional open repair. The same applies to the region of the aortic arch. Follow up examinations after TEVAR are of major importance in order to ensure long-term therapeutic success.