Objective: To evaluate the clinical efficacy of endovascular repair for aortic dissection during third trimester of pregnancy and early postpartum. Methods: The clinical records of 4 patients with pregnancy-related type B aortic dissection who underwent endovascular stent-graft repair were retrospectively analyzed. Of the 4 patients, aortic dissection in 2 cases occurred at 37 weeks of pregnancy, in one case occurred at 2 hours after delivery, and in one case occurred during the early postpartum period; 3 cases were diagnosed with Marfan syndrome (MFS), and the cause in one case was unknown. All patients underwent thoracic endovascular aortic stent-graft repair, and the assistant procedures included balloon dilation of aortic coarctation and insertion of chimney stent-graft into the left common carotid artery. The patients were followed by regular CT angiography monitoring at 1 month, 3 and 6 months after operation. Results: No maternal or child death occurred during the perinatal and follow-up period. One fetus was delivered via vaginal delivery and the other 3 fetuses were delivered by caesarean section. The aortic stent-grafts were successfully implanted in all of the 4 patients, with complete coverage of the primary tear in all cases and intentional coverage of the left subclavian artery in 3 cases, and there were no cases of type I endoleak or stent migration. In one patient with the primary tear located at the opening of the left subclavian artery, the landing zone was extended to the aortic arch and a chimney stent-graft was synchronously inserted into the left common carotid artery, and type II endoleak devolped after operation, which disappeared within the 11-month period of follow-up. The average follow-up time was 17.5 months, during which time, all the newborns survived, and one of them had neonatal jaundice that disappeared 12 d after delivery. Conclusion: Endovascular stent-graft repair has demonstrable short- and mid-term efficacy in treatment of type B aortic dissection during late trimester of pregnancy and early postpartum period. However, the timing and indications for repair should be determined with integrated consideration of the period of pregnancy and the clinical status of the patients.