We report a case of hypertensive heart failure with severe stenosis of the descending aorta. The patient had hyper-tension;therapy for 2 weks, he was admited to our hospital for acute heart failure. Computed tomography (CT) and mag-netic resonance imaging (MRI) showed severe arteriosclerotic stenosis of the descending aorta above the renal artery bifurcation. He underwent aortic resection and grafting. After surgery, his condition improved, and he was dis-charged.