Purpose Traditionally, “uncomplicated” type B aortic syndromes were treated with pharmacological management alone. Recent randomised and observational trials have suggested that endovascular intervention had beneficial effects on the risk of mortality related to aortic complications and progression of aortic disease (Nienaber et al., 2013) and that long term outcomes with only medical therapy are relatively poor (Durham et al., 2015) This study aims to determine the natural history of aortic syndromes based on current management guidelines and practices, looking particularly at outcomes after early intervention for uncomplicated Type B aortic syndrome Methodology Patients who presented to our institution with type B aortic syndromes since May 2016 were entered into the registry. After initially collecting data on their risk factors, specifics of their aortic pathology, and their management on presentation, follow-up data was obtained to determine outcomes and complication rates The primary outcomes were to determine survival duration after diagnosis with aortic syndrome, as well as cause of death and whether this was aortic related Results 100 patients with type B aortic syndrome entered the registry between May 2016 and June 2025. 58 were male and 42 female. Median age was 76 (range 39-97), 43 were treated with best medical therapy only, and 58 treated surgically of which 37 operations were within the first 7 days 30-day mortality was 3% (all in medical treatment group). All-cause mortality of 28%, with 19 in medical group and 9 in surgical group. 5 aortic cause mortalities in medical group, 2 in surgical group Conclusion We reviewed baseline patient factors and mortality outcomes for type B aortic syndromes within our centre, with majority of surgical interventions being within 7 days and no increase in perioperative mortality rates seen with treatment in this period. More ongoing research into the area is required to help for recommendations and guidelines for management of type B aortic syndromes