The purpose of this study was to review the shift in the trend of management and mid-term outcomes of all patients who sustain thoracic aortic injury. A Retrospective analysis was performed of all patients sustaining blunt thoracic aortic trauma admitted to our unit. Forty-seven patients were presented with injury to the thoracic aorta following blunt chest injury. Ten patients underwent open surgical repair of their thoracic aortic injury. The mean age ± SD (range) was 29.4 ± 7.9 years (18–41) with a mean Injury Severity Score (ISS) of 41 ± 14.7 (25–75). Fifteen patients underwent thoracic endovascular repair for blunt aortic transections with a mean age of 35.1 ± 14.5 years (17–65), mean ISS of 40.8 ± 13.9 (20–75) and an average length of hospital stay of 25.6 ± 14.5 days (3–77). The mean aortic diameter proximal to the aortic injury was 23.46 ± 3.02 mm (19–28) with a mean aortic angulation of 58.46° ± 17.73 (44–80°). The mean oversizing was 24.4 ± 5.4% (17–32%). At our institution, there has been a paradigm shift in the emergent repair of blunt thoracic aortic injury from open surgery to endovascular repair. Oversizing of the stent-graft did not translate to a poorer outcome.