Abstract: The development of minimally invasive endovascular technology has initiated a paradigm shift in the treatment of thoracic aortic disease. A fundamental understanding of the science and engineering of endovascular stent grafts is key to their appropriate implementation in practice. Furthermore, the rapid influx of new devices requires practitioners to make their decisions based on the relative strengths and weaknesses of the various products. Shape, wire thickness, coating, graft material selection, and imaging are just a few of the factors to consider in stent graft design. The ideal stent graft and delivery system would include the following characteristics: easy pushability, trackability, a high expansion ratio, low profile, and the ability to negotiate tight lesions and a tortuous course. The material needs to be biocompatible and resistant to thrombosis, stenosis, migration, and external compression. Although current designs continue to show significant advancements, there are clearly no ideal stent grafts. Each device has merits and drawbacks that need to be tailored to a specific clinical application.