Thoracic aortic diseases, including disease of the descending thoracic aorta (DTA), are significant causes of death in the United States. Open repair of DTA is a physiologically impactful operation with relatively high rates of mortality, paraplegia, and renal failure. Thoracic endovascular aneurysm repair (TEVAR) has revolutionized the treatment of DTA, and has largely supplanted open repair due to lower morbidity and mortality. These Society for Vascular Surgery (SVS) Practice Guidelines are applicable to the use of TEVAR for descending thoracic aortic aneurysm (TAA) as well as other rarer pathologies of the DTA. Many of the strongest recommendations from the present guideline focus on imaging either prior to, during or after TEVAR.