Thoracic aortic infections are rare clinical entities associated with an abnormal inflammation of the aortic wall and high morbidity and mortality. This chapter describes the management of thoracic aortic infections including pyogenic aortitis, myotic aneurysm, syphilitic aortitis, tuberculous aortitis, aortic valve endocarditis, infectious aortitis, prosthetic valve endocarditis, and thoracic graft infections, with emphasis on surgical management and care. Following an extensive literature search, a total of 86 articles comprising case reports, systematic reviews, meta-analyses, and original articles were reviewed for this chapter. Appropriate guidelines were also referenced where available. Management of thoracic aortic infections begins with timely diagnosis based on clinical findings, appropriate laboratory values, and imaging. Once diagnosed, depending on clinical presentation, antibiotics (and/or surgical intervention) are offered. Depending on the extent and the duration of the infection, different surgical options are available ranging from salvaging of the original graft to replacement with synthetic or tissue graft. Adequate follow-up with imaging is essential for good outcome.