Treatment of aneurysms of the descending thoracic aorta has made significant progress in recent years. Endovascular therapy (TEVAR) is currently regarded as the gold standard for this aortic segment and enables the treatment even of older and sicker patient groups. There are currently five international guidelines covering the treatment of aneurysms of the descending thoracic aorta published between 2010 and 2020. The following article presents a selection of 10 core recommendations from the current guidelines within the framework of the Choosing wisely initiative of the Association of the Scientific Medical Societies in Germany (AWMF). The aim is to transfer recommendations from the guidelines and other high-quality sources into routine practice, to question the usual care practices in Germany and to avoid overtreatment and undertreatment.