Introduction - There are few studies focusing on innominate artery (IA) chimney stent for patients with zone 0 thoracic aortic diseases. This study sought to report our single-center experience of IA chimney technique for zone 0 thoracic aortic diseases and the early to mid-term outcomes in these patients. Methods - From February 2015 to June 2017, 19 patients (19 males; mean age of 54.3±14.1 years, range from 34 to 77 years) underwent IA chimney stent combined with extra-anatomic bypass and thoracic endovascular aortic repair (TEVAR) for zone 0 thoracic aortic diseases in our center. Demographics, coexisting medical conditions, imaging features, operation details, and follow-up outcomes of these patients were retrospectively collected and analyzed. Results - Patients suffered from Stanford type B aortic dissection (n = 7), aortic arch aneurysm (n = 10), pseudoaneurysm of the aortic arch (n = 1) and aortic rupture (n = 1). Elective settings were performed in 84.2% (16/19) and emergent in 15.8% (3/19) of all patients. The technical success rate was 100% (19/19), and 22 chimney stents, including 15 uncovered and 7 covered stents, were implanted in 19 IAs. The overall immediate endoleak rate was 31.6% (6/19); type I endoleak was observed in five patients and type II in one patient. Chimney stent migration was observed in one case and another stent was deployed. Perioperative complications included death (5.3%, 1/19) due to severe stroke. The median follow-up period was 9 months (range 1–31 months). One patient died three months after the procedure due to aortic rupture. There was no collapse or occlusion of the chimney stent during the follow-up period. Conclusion - Our limited experience demonstrates that innominate artery chimney technique is a viable and relatively safe treatment strategy for patients with zone 0 thoracic aortic diseases. A larger series of cases with a longer follow-up is needed to substantiate these results.