Thoracic aortic aneurysms are life threatening because of the risk of rupture. Moreover, aneurysm enlargement can lead to additional complications, including bronchial and esophageal obstruction. We report an 80-year-old man with a 7-cm diameter thoracic aortic aneurysm resulting in near-complete left main bronchial obstruction and significant dysphagia. He had a number of intensive care unit admissions for respiratory failure and had lost more than 10 kilograms. Under spinal anesthesia, he underwent endovascular thoracic aortic aneurysm repair. Postoperatively, he had left main bronchial total obstruction treated with a bronchial stent. He then recovered uneventfully and was discharged to home.