Abdominal aortic dissection (AAD) is a rare and severe aortic disease that usually occurs in men and is closely associated with smoking, hypertension and hyperlipidemia. The clinical manifestations are diverse or even absent, which may easily lead to misdiagnosis, missed diagnosis and delayed treatment. Enhanced CT is the first choice for the diagnosis of AAD. Conservative treatment to control the blood pressure and heart rate combined with imaging follow-up is the most common initial treatment. When AAD progresses and has surgical indication, surgery treatment should be performed actively. Endovascular aortic repair (EVAR) is the first surgical choice. Open surgery is often used in patients with anatomic conditions that are not suitable for EVAR. A detailed preoperative evaluation and an appropriate operation plan are essential for the success of EVAR.