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30% of patients with blunt thoracic aortic injury (BTAI) can have concomitant traumatic brain injury (TBI), with mortality nearing 20%. Conflicting blood pressure goals may influence decision and timing of thoracic endovascular aortic repair (TEVAR). This study analyzed management and outcomes in patients with concomitant TBI/BTAI. Patients with concomitant TBI/BTAI and BTAI were identified in our trauma registry. Descriptive statistics and logistic regression compared management and outcomes. Twenty patients had concomitant TBI/BTAI. 46 patients had BTAI alone. 9(13%) patients with concomitant TBI/BTAI and 30(45%) patients with BTAI alone underwent TEVAR. There was no difference in overall mortality (OR 0.29, 0.05–1.55 CI, p ​= ​0.12), aortic-related mortality (x2 3.51, p ​= ​0.06), incidence of TEVAR (x2 1.59, p ​= ​0.10) or timing to TEVAR (t ​= ​−1.6056, p ​= ​0.06) between patients with concomitant TBI/BTAI and BTAI alone. There was no difference in outcomes or interventions in patients with TBI/BTA vs BTAI alone in this small, hypothesis-generating single institutional trial. [Display omitted] •Concomitant TBI/BTAI has a mortality around 20%.•Conflicting optimal blood pressure exists - higher for TBI, lower for BTAI.•BTAI repair should be considered in patients with concomitant TBI.•A larger multi-institutional trial is needed.