A 77-year-old man with severe chronic obstructive pulmonary disease was admitted to our hospital for surgical treatment of a proximal descending thoracic aortic aneurysm (dTAA) and an infrarenal abdominal aortic aneurysm (AAA). The patient had poor respiratory function; however, a simultaneous abdominal aortic replacement and thoracic stent-graft placement were successfully performed without any complications. This case report demonstrates that simultaneous abdominal aortic replacement and thoracic stent-graft placement for multiple aneurysms may be feasible and can safely be performed in selected high-risk patients, despite the many problems associated with the treatment of aortic aneurysms using stent grafts.