Objective To report the clinical outcome and complications of endovascular stent-graft treatment for type B aortic dissection in elderly patients, as compared with younger patients in a single medical center. Methods From May 2002 to July 2008, endovascular stent-graft implantation was performed in 124 patients with type B aortic dissection at the Department of Cardiology, Shenyang Northern Hospital. Among them, 39 patients were 60 yrs or older (ranging from 68 to 81 years) while 85 patients were younger than 60 years old (ranging from 31 to 58 years). Patients were followed up for a mean period of 26 months (ranging from 1 to 78 months). Clinical data were analyzed between the two groups. Results Comparing with the younger group, the elderly group had higher prevalence of coronary artery disease (59.0% vs 24.7%, P=0.001). There was no significant difference of complication rates between the 2 groups (38.5% vs 31.8%, P=0.54). Kaplan-Meier analysis showed a similar 5-year survival rate(80.2% vs 89.6%; Log Rank, P=0.31) between the 2 groups. Conclusions Endovascular stent-graft implantation is safe and effective in the treatment of type B aortic dissection for both elderly and younger patients. The procedure-related complication rate seems independent of age.