We report a case of thoracic aortic aneurysm and aortic valve stenosis with chronic renal failure requiring hemodialysis. A 75-year-old man complained of back pain and hoarseness. He had been on dialysis for 15 years. A computed tomography scan of the chest showed marked calcification in the thoracic aortic arch, which is known as a porcelain aorta, and a distal arch aneurysm. Echocardiographic examination showed moderate aortic valve stenosis with calcification. An operation was scheduled, and both the aortic valve and the aortic arch aneurysm were successfully replaced with a mechanical valve and a prosthetic graft. Cardiovascular surgery for patients complicated by a porcelain aorta requires extra cares for the establishment of cardiopulmonary bypass and anastomoses of the aorta.