Objective To analyze the clinical experiences and short-term outcomes of hybrid repair for aortic arch lesions in elderly patients. Methods Between February 2009 and February 2012, 11 patients (8 males, 3 females) with aortic lesions who cannot endure surgical operation, including 6 aneurysms, 3 ulcers and 2 dissections, mean age 70 years, underwent hybrid repair. Right axillary artery-left carotid and axillary artery bypass were performed to create a proximal landing zone by covering the origins of the left carotid and subclavian arteries and simultaneous implantation of an endovascular stent graft into the thoracic aorta was carried out. Computed tomographic angiography or magnetic resonance imaging was performed at 3, 6, and 12 months, and annually thereafter. Results Primary technical success rate was 100%. One case died at day 8 after operation. Two patients had a mild typeⅠ endoleak, which disappeared at 3 months and 6 months respectively. No case of stroke or paraplegia was reported. Ten patients survived after a mean follow-up of (15±10) months. There was no late aortic or neurologic events. Conclusion Hybrid repair is safe and effective for aortic arch lesions in the elderly with good short-term outcomes.