This report describes the clinical presentation, diagnosis, surgery and results of patients with acute traumatic rupture of the aorta in a series of 21 consecutive patients. Direct cross-clamping without additional methods of spinal cord protection was used in 18/21 patients (86%). Direct suture was possible in 12/21 patients (60%). In the remaining patients, the repair was carried out by interposition of a Dacron graft. Overall mortality was 7/21 patients (33%). However, in 3 patients with severe polytrauma irreversible brain damage was the cause of death whereas 2 patients died from septicemia and myocardial infarction, respectively. No paraplegia nor paraparesis occurred in the surviving patients which were operated by direct cross-clamping of the aorta and rapid reanastomosis without additional methods of spinal cord protection.