Aortic root/ascending segment, due to its complex anatomical structure and hemodynamic turbulence characteristics, requires consideration of several factors such as "aortic valve, bilateral coronary artery openings, aortic sinus dilation, and innominate artery opening" when designing endovascular grafts. Therefore, it is regarded as the final "forbidden zone" for endovascular repair, and to this day, there is still no ideal intraluminal graft available for treating lesions in this segment, becoming a forefront issue focused on by major vascular surgery centers worldwide. Current research strategies include the Endo-Bentall procedure, Endo-Wheat procedure, and "Jing's valved-fenestrated endografting" animal experiments, but significant challenges remain unresolved, such as individualization limitations, unclear long-term patency of coronary stents, and graft infections. Currently, there are no perfect endografts or endovascular surgical approaches to address lesions in the aortic root-ascending aorta segment. Given the limitations of the current technology and limited clinical experience, this technique should be reserved for high-risk patients, especially those who refuse open interventions. Here, the authors provide an overview of the currently available endovascular repair options involving the aortic root and ascending aorta lesions.