Aim. To compare the results of open surgery and stenting for descending thoracic aortic aneurysms. Material and methods. The study included 127 patients with descending thoracic aortic aneurysms. Patients were divided into 2 groups depending on type of intervention (open vs. TEVAR). In-hospital and long-term clinical results, major complications and survival were compared. Results. Technical success of stenting was achieved in 98.6%. In-hospital mortality was 5.2% in surgical group and 0% in endovascular group (OR 0.12, 95% CI 0.006—2.3; p=0.16). Permanent paraplegia and 30-day mortality were observed in 1.7% in surgical group. One case of acute cerebrovascular accident was observed in every group (1.7 and 1.4%, respectively, p=0.9). In-hospital aggravation or appearance of renal failure was observed in 5.2% (open surgery) and 1.4% (stenting) (p=0.26). 4 (6.9%) patients after open surgery and 1 (1.4%) patient after stenting required prolonged intubation (p=0.16). Cumulative risk of in-hospital complications was significantly lower in the 2nd group (OR 0.19, 95% CI 0.06—0.65; p=0.008). Overall 8-year survival was 74.3 and 68.7% in both groups respectively (p=0.48). Conclusion. TEVAR is accompanied by significantly lower incidence of in-hospital major complications compared with open surgery. The long-term survival is similar after both surgical methods.