Objective To observe the hemostatic effect of pre-arranged pericardial wrapping in total arch replacement for type A aortic dissection (AAD). Methods The data of 35 patients who were diagnosed as AAD and underwent total arch replacement with pre-arranged pericardial wrapping hemostasis in our hospital from Jan. to Nov. 2021 were retrospectively analyzed. Thirty-five AAD patients who underwent total arch replacement with traditional hemostatic methods in the same period were selected as controls. The intraoperative conditions (including the aortic root treatment, cardiac arrest time, cardiopulmonary bypass time, operation time, and blood transfusion during surgery), early postoperative blood coagulation function (including the platelet count, prothrombin time, fibrinogen concentration, K time, and maximum clot strength 1 d after operation), and postoperative recovery (including the drainage volume 24 h after operation, the second thoracotomy for hemostasis, mechanical ventilation time, hemofiltration, and intensive care unit［ICU］ admission time) of the pre-packaged group and the control group were observed. Results There were no significant differences in the aortic root treatment, cardiac arrest time, the second thoracotomy for hemostasis, mechanical ventilation time, hemofiltration, or ICU admission time between the 2 groups (all P＞0.05). Compared with the control group, the pre-packaged group had shorter cardiopulmonary bypass time and operation time, and less blood transfusion during the operation (all P＜0.05). Compared with the control group, the pre-packaged group had higher platelet count, fibrinogen concentration, maximum clot strength, and shorter prothrombin time and K time 1 d after operation (all P＜0.05). The drainage volume 24 h after operation in the pre-packaged group was less than that in the control group (P＜0.05). Conclusion Pre-arranged pericardial wrapping for hemostasis in AAD total arch replacement can reduce operation time and perioperative blood loss, protect the coagulation function of patients, and help patients recover after surgery, so it can be used as a clinical hemostasis method.