Objective: To investigate the effect of aortic esophageal fistula treatment after thoracic aortic endovascular repair (TEVAR) with artificial vessel bypass. Methods: The clinical data of 6 consecutive patients who received surgical treatment at Shanghai Deda Hospital from September 2019 to June 2021 due to aortic esophageal fistula after TEVAR were retrospectively analyzed. There were 6 males, aged (47.7±8.2) years old (range: 35-56 years old). All patients had recurrent fever, and 4 patients had positive blood cultures. According to the specific conditions of the patients, all patients underwent artificial blood vessel bypass and jejunostomy under general anesthesia without extracorporeal circulation. One case underwent artificially infected vascular segment resection and esophageal repair at the same time. 5 cases underwent artificial infection vascular resection, 4 of them underwent esophageal repair, and 1 case had a large intraoperative fistula and local resection of the esophagus. Sensitive antibacterial drugs were continued after the operation for 6 to 8 weeks. Results: There were 2 deaths in hospital, 1 case of large cerebral infarction early postoperatively, and 1 case of septic shock. The remaining 4 patients recovered well after the operation and were discharged. The follow-up period was 2 to 23 months. During the follow-up period, the remaining patients had no recurrence of infection and esophageal fistula. Conclusion ：In patients with aortic esophageal fistula after TEVAR, the establishment of artificial vascular bypass, the resection of the infected vascular segment, contemporaneous or staged esophageal repair, regular anti-infective treatment can obtain a good prognosis.