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Aortic disease, known for centuries, originally resulted from infectious processes or trauma. Treatment programs were primarily symptomatic and included diet and rest. The timeline for a vascular concept and disease development along with successful treatment programs has been slow and punctuated by multiple failures. With the scientific and community developments of the 1800s, such as electricity, the germ theory, the improved understanding of the cardiovascular system and circulation, along with anesthetics, the past 150 years has seen a progressive change in the diagnosis and successful treatment of aortic diseases whether infectious, obstructive, hemorrhagic, or aneurysmal in nature. Evolution has seen the virtual disappearance of syphilitic aneurysms and the appearance of atherosclerotic degenerative aneurysms, obstructive aortic disease, aortic dissection, inflammatory and genetic lesions. Our timeline progresses through nearly 2000 (especially the last 200) years of vascular and aortic disease diagnosis and treatment.