Thoracoabdominal aneurysms are relatively less common aneurysm but are complex cases to manage. They extend on both sides of diaphragm to involve a variable portion of aorta. They become challenging as different cavities of body are involved and many abdominal visceral branches originate from this segment of aorta along with spinal and intercostal arteries as well. There may be fatal damage to these organs during surgery as a result of temporary occlusion of these arteries to facilitate bloodless field for surgery. In this study, we have specially emphasized on considerations of surgery of these complex aneurysms.