Background: Ortner syndrome refers to vocal cord paralysis resulting from compression of the left recurrent laryngeal nerve by abnormal mediastinal vascular structures. This retrospective case series details our experience with Ortner’s syndrome due to thoracic aortic aneurysm. Methods: This study was a retrospective analysis of a case series. A total of 4 patients (mean age, 65.5 years) with Ortner’s syndrome due to thoracic aortic aneurysm who underwent thoracic endovascular aortic repair from July 2014 to May 2020. The patients’ demographics, comorbidities, initial symptoms, time from hoarseness to treatment, aneurysm shape and size, surgical procedures and outcome were summarized. Results: A total of 4 patients with Ortner’s syndrome due to thoracic aortic aneurysm were analyzed. All of them underwent thoracic endovascular aortic repair with no complication during hospitalization period. At a mean follow-up of 26.8 (8-77) months, 3 patients’ hoarseness had completely resolved or improved, one patient’s symptoms had not progressed. Conclusions: Hoarseness due to left recurrent laryngeal nerve palsy can be the presenting symptom of thoracic aortic aneurysm. Early diagnosis leads to timely treatment of these patient which may be helpful to functional recovery of the symptoms.