Background <p>The optimal treatment of complicated type B aortic dissection (cTBAD) involving arch anomalies remain unclear.</p> Methods <p>We consecutively enrolled patients with cTBAD involving arch anomalies who underwent endovascular repair using a single-branched stent graft (SBSG) at our medical center between January 2020 and January 2023. The demographics, clinical manifestation, operation detail, and follow-up outcomes of these patients were retrospectively collected and analyzed.</p> Results <p>A total of 16 patients (14 men; 55.8 ± 11.7&#xa0;years) were enrolled, including isolated left vertebral artery (ILVA) (<i>n</i> = 6), aberrant right subclavian artery (ARSA) (<i>n</i> = 7), and right aortic arch and aberrant left subclavian artery (ALSA) with Kommerell’s diverticulum (KD) (<i>n</i> = 3). Among them, six patients with multi-branched arch anomalies. The endovascular management strategies of patients were diverse based on their aortic morphology. The early outcome demonstrated that one patient experienced an immediate intraoperative type I_a endoleak, which was resolved by balloon dilation, and two patients exhibited bird-beak configuration. After a median of follow-up of 910 (743–1023) days, the long-term outcome revealed that two patients developed endoleak. No death, retrograde type A aortic dissection (RTAD), paraplegia, stent graft-induced new entry tear (SINE), or branch section stenosis of SBSG were observed during the follow-up.</p> Conclusion <p>Our limited experience suggests that endovascular repair with a SBSG appears to be a relatively safe, feasible, and effective treatment option for patients with cTBAD and arch anomalies.</p>