A case of occlusion of the thoracic aorta after traumatic rupture of the aortic isthmus is presented.Despite successful operation with restoration of distal pulses, death occurred because of the prolonged preoperative period of ischemia, with severe postoperative uncontrolled acidosis, hepatic and mesenteric ischemia, and paraplegia.Death following traumatic rupture of the thoracic aorta is usally related to rapid exsanguination but rarely to ischemia after aortic occlusion by the periaortic hematoma.