Antegrade cerebral perfusion (ACP) and retrograde cerebral perfusion (RCP) are the two major types of brain protection during aortic arch surgery. Which one is better has still been debated. By summarizing and analyzing the research progress of the comparative research of antegrade cerebral perfusion and retrograde cerebral perfusion in aortic arch surgery, we have found that there was no significant difference between ACP and RCP in terms of temporary nerve dysfunction (TND), permanent nerve dysfunction (PND), stroke, early mortality, morbidity, long-time survival, and a composite outcome of hospital death, bleeding, prolonged ventilation, need for dialysis, infection and stroke. But RCP resulted in a high incidence of prolonged mean ICU-stay and hospital-stay, longer mean extubation time as well as higher cost. And the surgeon is given more time to reconstruct the vessels of the arch since mean operative time is longer in the ACP. So we think that antegrade cerebral perfusion might be preferred as the brain protection method for complicated aortic arch procedures. If a surgeon confirms that the surgery is not very sophisticated and can be completed in a short time, it is better to choose RCP because of no catheter or cannula in the surgical field to impede the surgeon. The article aims at providing a reference to cardiac surgeries when choosing cerebral protection strategy in aortic arch surgery.