Forty-two patients underwent replacement of the thoracic aorta with a sutureless intraluminal graft. Early and long-term results were evaluated. The operative mortality rate was 7.1%. There were two postoperative complications related to a ringed graft. One complication, the formation of a pseudoaneurysm, was caused by insufficient fixation of the graft; the other, a cerebral infarction, was related to the location of the proximal anastomosis with respect to the origin of the left subclavian artery. The 3- and 5-year actuarial survival rates were 86 and 69.5%, respectively. These were similar to survival rates of age-matched controls in the general Japanese population. Replacement of the thoracic aorta using a sutureless intraluminal graft can be performed with acceptable operative mortality, with good long-term results.