To evaluate and analyze aortic remodeling following endovascular repair of blunt traumatic aortic injury (BTAI) patients and correlate relevance to overall clinical outcomes. An IRB approved institutional review of thoracic endovascular aortic repair (TEVAR) for BTAI between 2006-2014 was performed from a prospectively maintained database. Pre-procedure and post-procedure computed tomographic angiograms (CTA) were analyzed for significant anatomic remodeling including mean aortic diameter change and unfavorable endograft configurations such as “bird-beaking,” in-folding, migration, and endoleak. These variables were correlated with endograft type and need for secondary interventions. 29 patients underwent TEVAR for BTAI between 2006 and 2014. Of the 29 patients, 17 had follow up imaging (ranging 30 days to 5.7 years). Six of the 17 patients (35%) had coverage of left subclavian artery. One patient required carotid to subclavian artery bypass. Despite mean endograft oversizing of 18%, aortic diameters in the proximal and distal seal zones showed minimal increase in size from baseline (1.7+/- 1 mm). One patient had significant increase in aortic diameter post procedure (> 5 mm) with development of a penetrating aortic ulcer above the endografted segment. Bird’s beak configuration was seen in 3 of 17 patients (17%); non-conformable type endografts (not Gore ® C-TAG or Medtronic ® Valiant Captivia) were involved in all cases. Two patients had persistent type I endoleaks, both with non-conformable grafts. One patient required conversion to open repair due to aneurysm expansion. There were no instances of graft infolding or graft migration. Mural thrombus in the endografted segment of the aorta was seen in 7 patients (41%) without clinical sequelae in the follow up period. Aortic remodeling is an expected occurrence following TEVAR for BTAI. Unfavorable clinical outcomes were associated with older generation non-conformable endografts. Further evaluation of post TEVAR aortic remodeling in BTAI is needed as potentially clinically relevant changes such as mural thrombus development is seen in a significant number of these patients regardless of graft type.