Objective To evaluate the effect of the pre-operative health status on outcome of thoracic endovascular aortic repair (TEVAR) in patients with type B aortic dissection (T_BAD). Methods The clinical data of 328 T_BAD patients, who underwent TEVAR between September 1998 and December 2011, were retrospectively analyzed. The patients were divided into ASA≤3 group and ASA>3 group according to American Society of Anesthesiologists (ASA) classification before TEVAR. Univariable and multivariate Cox proportional hazard regression model analysis were used to evaluate the difference in outcomes of patients in the two groups. Results There was no significant difference in the complication rates between the two groups during the peri-operation period. During follow-up, the all-cause mortality rates and risks of transferring to open operation were similar between the two groups; however, patients in ASA>3 group had a significantly higher re-TEVAR rate than those in ASA≤3 group (Hazard ratio=2.50, 95% CI: 1.05-5.91, P=0.037). Conclusion TEVAR is a safe alternative for T_BAD patients. Poor pre-operative health status has negative effect on the postoperative outcome of TEVAR. Patients with a good health status are suitable for TEVAR.