Ruptured thoracic mycotic aneurysm is fatal, and surgical resection of the aorta may be unavailable because of occurrence of preoperative shock in such a patient. In the present case, the thoracic mycotic aneurysm ruptured during hospital stay, causing acute hypovolemic shock but was successfully repaired by thoracic endovascular aortic repair (TEVAR) with video-assisted thoracic surgery (VATS) drainage.