Objective: To determine the efficacy of hybrid approach for treatment of distal aortic arch diseases. Methods: The hybrid procedures (endovascular repair combined with extra-anatomic bypass procedure) were performed in 10 patients, of whom, 4 cases were type B aortic dissection involving the branches of aortic arch and 6 cases were true aneurysm of the distal arch. The bypass surgery of the patients included 1 case of left common carotid artery to left vertebral artery bypass, 5 cases of right common carotid artery to left common carotid artery bypass, 1 case of right common carotid artery to the left common carotid artery and left common carotid artery to the left subclavian artery bypasses, and 3 cases of ascending aorta to innominate artery and left common carotid artery bypasses. The covered-stent grafts of all patients were implanted via femoral artery. Results: Technical success was achieved in all patients, but there was one case of a minor type I endoleak that was left without intervention. Except for 1 patient who developed cerebral infarction complicated with pneumonia and renal failure after surgery and was discharged against medical advice, the remaining 9 patients were discharged from hospital after they were cured. Nine patients were followed up for 3 to 33 months. The CTA examination at 3 months after surgery showed no evidence of stent migration, the former endoleak in one case had disappeared, no new endoleaks occurred; thrombus formation was observed in the false lumen of aortic dissection and in aneurysmal cavity, no enlargement of the distal false lumen was found, and the bypass prostheses were patent. Conclusion: Hybrid treatment can avoid the complications of extracorporeal circulation, reduce the degree of surgical trauma and improve the therapeutic outcomes of the patients, and is an important method for treatment of distal aortic arch diseases involving the aortic branches.