Spinal cord ischemia after surgery of thoracoabdominal aortic aneurysm is still one of the serious complications encountered. We adopted a surgical technique with reconstruction of intercostal arteries together in 3 cases in order to prevent intraoperative spinal cord ischemia. The posterior wall of the aorta, including the intercostal arteries, was trimmed and seamed, then anastomosed to the branched graft to the stem graft under deep hypothermia. This technique is simply performed with a running suture and enabled reconstruction of the intercostal arteries together below the fourth intercostal artery. Postoperative complications due to spinal cord ischemia or aneurysmal change of the reconstructed aorta have not appeared in the 4 years since operation.