Acute aortic dissection is an acute state that potentially could be fatal. It is caused by the separation of two layers of the aortic wall and allowing blood flow to enter creating two lumens, one true lumen and one false. The most common cause of acute aortic dissection are unregulated hypertension, smoking, aneurysms and male gender. There are also genetic predispositions as Marfan’s syndrome and Ehlers-Danlos syndrome. Clinical signs of acute aortic dissection are not always clear and that is why acute aortic dissection are often misdiagnosed. The most common symptoms described by patients are severe, sharp pain in the chest and the diagnoses should be suspicions from the anamnesis. One of the indications are usually the abruptness of the pain. Acute aortic dissection can proven by computed tomography. Acute aortic dissections are classified into two groups. This is type A and type B. The importance of the classification is because this tells us about location of dissection and the management and treatment options. Acute aortic dissections are treated by surgery or by medication. Surgery procedure choice depend if the aortic valve is damaged or not. Bentall procedure, valve sparing aortic root replacement and thoracic endovascular aortic repair are three most common procedures used for aortic dissection repair.