Background: To compare the outcomes of hybrid endovascular and open surgical repair for proximal aortic arch diseases. Methods: A total of 55 consecutive patients with an aortic arch aneurysm or aortic dissection involving any of zone 0 to 1 (39 male, age 63.4±14.3 years) who underwent a hybrid endovascular repair (n=35) or open surgical repair (n=20) from 2006 to 2014 were included in a retrospective analysis. Perioperative and late outcomes were compared. Results: The two groups had similar baseline characteristics, except age and EuroSCORE II, which were higher in the hybrid group. Perioperative mortality or stroke did not differ significantly between the two groups, but tended to be lower in the hybrid repair group than in the open repair group (11.4% vs. 30.0%, p=0.144). Incidences of other morbidities did not differ. During follow-up, similar over-all survival was observed between the hybrid group and the open repair group (87.3% vs. 79.7% at 1 year and 83.8% vs. 72.4% at 3 years; p=0.319). However, significantly lower reintervention-free survival was observed for hybrid repair compared with open repair (83.8% vs. 100% at 1 year and 65.7% vs. 100% at 3 years; p=0.022). Conclusions: Comparable perioperative and late outcomes were observed for hybrid endovascular repair of proximal aortic disease compared with open surgical repair, despite a higher reintervention rate during follow-up. Therefore, hybrid repair may be considered as an acceptable treatment alternative to surgery, particularly in patients at high surgical risk.