The repair of thoracoabdominal aortic aneurysm (TAAA) require a range of surgical techniques and is associated with serious complications such as paraplegia, gastrointestinal complications and acute kidney injury. In this report, we present a case of successful giant TAAA repair. Repair was performed from proximal to distal by sequential aortic cross clamp-and-sew under normothermia in this case. To prevent visceral, renal and spinal cord ischemia, organ protection was supplemented with cerebrospinal fluid drainage, renal perfusion and selective visceral perfusion in this case.