Objective To investigate the clinical characteristics, short-term and long-term prognosis and influencing factors of patients with Stanford type A aortic dissection (TAAD) complicated with postoperative hypoxemia. Methods Seventy-three patients with TAAD confirmed by chest CT and (or) aortic CT angiography in the First Affiliated Hospital of Chongqing Medical University from January 2017 to March 2021 were enrolled. According to whether the postoperative hypoxemia was complicated with, patients were divided into two groups: with hypoxemia group (n=36) and without hypoxemia group (n=37). The clinical characteristics of TAAD patients with hypoxemia were analyzed. Logistic regression model and Cox proportional risk model were used to analyze the effect of hypoxemia on the short-term and long-term all cause death of TAAD patients. Results The average age and BMI level were significantly higher in TAAD patients with hypoxemia group than those in without hypoxemia group, and the preoperative levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin (ALB), serum creatinine(Scr), urinary microalbumin (mALB) and TNF-α, IL-6 and high-sensitivity C-reactive protein (hs-CRP) were also significantly higher in with hypoxemia group than those in without hypoxemia group (P<0.05). The short-term mortality was significantly higher in with hypoxemia group than that in without hypoxemia group [22.2% (8/36) vs. 5.4% (2/37); χ²=4.365, P=0.037], but no significant difference between the two groups of patients in the long-term mortality after discharge [13.9% (5/36) vs. 8.1% (3/7);χ²=0.625, P=0.429]. Multivariate logistic regression analysis showed that complication with hypoxemia, age and TNF-α level were the independent risk factors for postoperative short-term hospitalization death in TAAD patients (P<0.05). Multivariate Cox regression analysis showed that age and hs-CRP level were the independent risk factors for death of TAAD patients during follow-up after discharge (P<0.05). While complication with hypoxemia was not an independent risk factor for death of TAAD patients during follow-up after discharge (P>0.05). Conclusion TAAD patients with postoperative hypoxemia have the clinical characteristics of old age, high BMI, high liver and kidney function index and high levels of inflammatory factors, and short-term postoperative death may increase.