Revascularization of the supraaortic branches represents a critical aspect of vascular surgery, solving complex pathologies involving the arteries that supply blood to the head and upper extremities. This paper provides an overview of the current state of complex revascularization procedures. Advances in imaging techniques, perioperative management, and surgical equipment have significantly improved the precision and safety of supraaortic branch revascularization. The integration of endovascular approaches, such as angioplasty and stenting, in addition to traditional open surgical methods, has expanded the treatment tools for a diverse range of vascular pathologies. However, challenges remain, including the intricacies of patient selection, optimal choice of revascularization technique, and management of perioperative complications. Patient-specific factors, such as anatomic variations, comorbidities, and the presence of complex lesions, require a tailored approach to achieve optimal outcomes. Balancing the potential risks and benefits of different revascularization strategies remains a complex decision-making process.