Aortic diseases have been diagnosed and studied by physicians for centuries. Aortic dissection was described for the first time in the second century and was typically characterized as an intimal tear developing and permitting entry of blood to a diseased underlying media. Propagation of the dissection can proceed in anterograde or retrograde fashion from the initial tear involving side branches and causing various complications. George II, the King of England, had sustained fatal cardiac tamponade caused by an acute type A aortic dissection in the XVIII century. Over the course of more than 200 years, attempts to treat the aortic dissection were unsuccesstul. Only in 1955 aortic dissection had been successtully managed for the first time by DeBakey. Much has been learned about the risk factors, clinical characteristics, diagnosis, and management of acute aortic dissection over the last decades. Technological advances in imaging techniques and a better understanding of the pathophysiology of acute aortic dissection have led to the discovery of variants of aortic pathologies now called acute aortic syndromes. As a result of knowledge and interest in this area, the outcomes of patients treated for acute aortic syndromes have improved. However, the mortality rate remains high. This review discusses the epi demiology, causes and pathogenesis, classification, clinical presentations, diagnostic modalities, management options and outcomes of aortic dissection. Literature searches of the PubMed and Springer LINK databases were conducted using the following keywords: aortic dissection, acute aortic syndrome. The papers included in this review are all published in peer-reviewed journals.