The surgical treatment of thoraco-abdominal aortic aneurysm is a unique solution completed by multidisciplinary cooperation. Preoperative detailed examination and evaluation should be carried out to determine the appropriate point for surgery and optimize the organ function through necessary means. During perioperative period, excellent surgical skills and appropriate strategy of extracorporeal circulation will be adopted according to the scope of involvement, and necessary measures will be utilized to monitor and protect the functions of vital organs. Close monitoring and management in postoperative stage, early warning of complications and effective treatment are essential ways to improve the prognosis of TAAA surgery. This article reviews the research progress in perioperative management of TAAA surgery.