Since the approval of commercially manufactured stent grafts in Japan in 2008, thoracic endovascular aortic repair (TEVAR) has rapidly gained popularity as an alternative treatment for high-risk patients due to its advantage of not requiring a large thoracotomy or cardiopulmonary bypass. TEVAR has also been attempted for acute Stanford type B aortic dissections, leading to a paradigm shift in treatment strategies. To successfully perform TEVAR, meticulous preoperative preparation is essential, similar to open surgery. This paper aims to provide an overview of the practical aspects of TEVAR.