Penetrating atherosclerotic ulcers are a rare condition characterized by the ulceration of an aortic atherosclerotic plaque penetrating through the internal elastic lamina into the aortic media. Despite the lack of consensus on optimal management of this disorder, we successfully treated two patients with penetrating atherosclerotic ulcers using an endovascular method. We present our observations and experiences regarding endovascular treatment of penetrating atherosclerotic ulcers of the thoracic aorta.