Aortic dissection is the most common catastrophic condition affecting the aorta. Its clinical presentation is variable and can mimic any number of medical and surgical conditions. The most prevalent symptom is excruciating chest pain. Essential treatment includes rapid initiation of pharmacologic agents to control hypertension. Aortic dissection involving the ascending aorta also necessitates immediate surgical repair. Surgical treatment of aortic dissection involving only the descending aorta generally is reserved for patients with persistent pain, intractable hypertension, or evidence of propagation of the dissection. Nursing management includes blood pressure monitoring, serial physical assessment, and postoperative care, as appropriate.