Objective：To investigate the midterm outcomes of thoracic endovascular aortic repair（TEVAR）combined with left subclavian artery（LSA）fenestration for aortic arch diseases. Methods：We retrospectively analyzed the perioperative period and midterm follow-up clinical data of 111 patients who underwent TEVAR combined with LSA fenestration in the First Affiliated Hospital of Nanjing Medical University from January 2018 to December 2021. Results：Overall，the success rate of the surgery was 100%（111/ 111），the mortality rate within 30 days was 3.6%（4/111）. The median postoperative follow-up time was 33.0 months，the all-cause mortality was 6.3%（7/111），the aorta-related mortality was 2.7%（3/111）. Among the main complications，there were 3 patients（2.7%） of cerebrovascular accident，2 patients（1.8%）of paraplegia，1 patient（0.9%）of retrograde type A dissection（RTAD），2 patients （1.8%）of endoleak，and 3 patients（2.7%）of distal stent -induced new entry（dSINE）. Four patients（3.6%）underwent the second aortic intervention，of which 3 patients（2.7%）were performed endovascular surgery and 1 patient（0.9%）was performed thoracotomy and artificial vascular replacement. Conclusion：The mid -term outcomes of TEVAR combined with LSA fenestration for aortic arch diseases were within the acceptable range，however，further follow-up results are needed and long-term stability and durability needs to be assessed. In addition，the technical process of fenestration needs to be standardized and unified，and related equipment needs to be further developed.