We experienced 4 cases of thoracoabdominal and suprarenal abdominal aortic aneurysm in the last 6 months. There were 3 males and 1 female ranging in age from 43 to 66 years, 2 with an etiology of aortitis syndrome, 1 with non-specific inflammation and 1 with atherosclerosis. In all cases the modified Hardy procedure was employed. A 18 to 22mm X 9 to 11mm bifurcation, double velour woven dacron graft was sutured from the side of the lower descending thoracic aorta to the side of both common iliac arteries. Grafts of the same kind as above 6 to 7mm in size were attached from the main graft to major visceral arteries by end-to-end or end-to-side anastomosis. A permanent aortic-excluding clamp was attached to the normal aorta just proximal to the aneurysm. Another clamp, or double ligature with silk, was placed on the lower abdominal aorta or both common iliac arteries distal to the aneurysm. No renal and spinal preservation of any kind was employed, but renal failure and paraplegia were not recognized in any of the cases. One patient died 2 days and another 21 days after the operation due to uncontrollable bleeding and multiple organ failure. The other two are doing well.