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This study aimed to evaluate the outcomes of surgical strategies for DeBakey typeⅢ retrograde Stanford type A dissection(RAAD), Methods:We retrospectively analyzed 46 patients with RAAD treated at our hospital, Surgical procedures included ascending aorta repair(AAR, n=20), total arch replacement(TAR, n=17), and thoracic endovascular aortic repair(TEVAR, n=9), Early and late outcomes were assessed, Results:The AAR group had shorter operative times but a higher incidence of long-term aortic-related mortality, The TAR group showed no long-term aortic-related mortality but experienced early complications such as spinal ischemia, In the TEVAR group, several patients required early reintervention, Conclusion:An individualized surgical strategy is essential for the management of RAAD, While secure entry closure may improve long-term outcomes, each approach carries specific risks, AAR and TEVAR remain appropriate options for selected cases.