The patient was a 76-year-old man. He was referred to our hospital to treat Kommerell's diverticulum and aneurysmal right-sided aortic arch with aberrant left subclavian artery. We performed extended aortic arch replacement using gull-wing approach. He was discharged uneventfully without any complication. Gull-wing approach method has an advantage of wide surgical field and may be useful for extensive thoracic aortic disease.