Aim — to determine optimal surgical approach in redo thoracoabdominal aortic surgery. Material and methods. There were 34 redo thoracoabdominal aortic interventions for the period 2010—2016 at the Department of Aortic Surgery of Petrovsky Russian Research Center of Surgery. Mean aortic diameter was 7.3±1.5 cm. In 47% of cases aneurysm was combined with dissection DeBakey type III, false aneurysm rupture was diagnosed in 12% of cases. Following operations were performed: 1) conventional open surgery: thoracoabdominal aortic replacement in 32 (94%) patients including Coselli procedure (n=9) and Crawford procedure (n=23); 2) «hybrid» approach: visceral debranching (n=2, 6%) followed by aortic stenting. Results. Intraoperative mortality was absent. Mean time of aortic clamping was 64.2±7.5 min, CPB — 106.3±36.5 min, LA-FA bypass — 73.7±19.7 min. 30-day and in-hospital mortality was 8.8% (n=3). 1- and 3-year survival was 91% and 88%, respectively. 1-year patency of all branches was 97%. Conclusion. Individual approach is required to determine treatment strategy due to various lesion of thoracoabdominal aorta. In low and medium risk patients primary radical surgery reduces the likelihood of redo interventions in future. In high risk patients «hybrid» techniques provides the most radical treatment with lower incidence of postoperative complications.