Introduction. The aim of this study is to investigate on efficacy and long term results of the stent-graft treatment for diseases of descending thoracic aorta. Materials and Methods. During the last four years 129 patients were studied. They were divided into four groups: A) aneurysms (n=41), B) post-traumatic lesions (n=24). C) type B dissection (n=42), D) patients with chronic type B dissection not suitable for endovascular treatment (n=22) treated by medical therapy only. Results. An optimal procedure was achieved in 95% of the patients, discharged within 6 days. A total of 4 hospital deaths resulted in an operative mortality of 3.1%. 7 patients (6.5%) died during the follow-up while a 31.8% mortality (p<0,001) was observed within the medical treatment group. Conclusions. Endovascular treatment of thoracic aortic disease may represent a valid option, especially when compared to medical therapy.