ObjectiveTo review the research status of aortic arch management in type A aortic dissection (TAAD), aiming to provide a reference for surgical decision-making. MethodA comprehensive literature search was conducted on aortic arch management techniques globally. ResultsCurrent studies indicate that there are three main management strategies for TAAD: open surgery, endovascular repair, and hybrid surgery. Open surgery remains the gold standard for TAAD treatment, but it is associated with high perioperative mortality and postoperative complication rates. Although endovascular repair can reduce the incidence of complications, its technical complexity limits widespread adoption. Hybrid surgery is associated with lower complications rate. However, the lack of long-term multicenter studies and follow-up data means its long-term prognosis remains uncertain. ConclusionsAs one of the most critical emergencies in cardiovascular surgery, TAAD is characterized by rapid onset and high mortality. Therefore, it requires immediate intervention. Open surgery remains the current gold standard for treating TAAD, yet it is associated with clinical challenges such as high perioperative mortality and postoperative complication rates. Future research should focus on addressing these issues without compromising surgical success rates.