【Abstract】 Objective To determine the risk factors of delayed recovery following aortic arch surgery with deep hypothermic circulatory arrest (DHCA) in combination with antegrade selective cerebral perfusion (ASCP). Methods We retrospectively analyzed the clinical data of 97 patients who underwent aortic arch surgery under DHCA+ASCP between September 2004 and June 2013 in Nanjing Drum Tower Hospital. The patients were divided into two groups according to whether the consciousness recovered in 24 hours after the operation. In the normal group (n=46), there were 37 males and 9 females with an average age of 48.07±10.91 years. In the delayed recovery group (n=51), there were 40 males and 11 females with an average age of 52.18±11.40 years. We observed the clinical data of the patients in both groups and the risk factors of delayed recovery after aortic arch surgery were evaluated by single factor analysis and multivariate logistic regression analysis. Results Among all the patients, delayed recovery occurred in 51(52.58%), 11（11.34%）of whom had been continuously unawakened. Hospital mortality is 20.62%. Advanced age (>60) (p=0.030), hypertension disease (p=0.005), emergency surgery (p=0.031), CPB time>240 min (p=0.017), aortic cross-clamp time>180 min (p=0.021) and blood transfusion of RBC suspension>21U are the risk factors for delayed recovery. Emergency surgery (p=0.005) and CPB time>240 min (p<0.001) are independent determinants for delayed recovery. Conclusion No single risk factor explained the onset of delayed recovery. Rather, a combination of factors, especially emergency surgery and longer CPB time produced the highest odds of deficit.