Objective: To investigate the diagnosis and treatment strategy of spontaneous isolated superior mesenteric artery dissection (SISMAD). Methods: The clinical data of 3 SISMAD patients treated in the Department of Vascular Surgery of Xiangya Hospital of Central South University from October 2012 to May 2013 were retrospectively analyzed. The clinical manifestations, imaging features, treatment strategy options and prognosis of the SISMAD patients were summarized. Results: Of the 3 SISMAD patients, 2 cases were male and one case was female; the clinical symptoms were abdominal pain with nausea and vomiting; pre-treatment CTA showed the formation of an intimal flap separating the true and false lumen in the superior mesenteric artery, which was identified as Sakamoto type II in 2 cases and type III in one case; no case was complicated with dissection rupture or bleeding, or intestinal necrosis. All of the 3 patients underwent initial anticoagulant therapy with low-molecular-weight heparin calcium, and then endovascular stent placement. No severe complications occurred and the abdominal pain of the patients was alleviated after treatment. Follow-up was conducted for 2 to 8 months; the 3 cases were all alive, their symptoms disappeared, and the stents were patent. Conclusion: CTA is recommended in patients suspicious for SISMAD to confirm the diagnosis, and endovascular stent placement based on anticoagulant therapy is a safe and effective treatment modality for those without dissection rupture/bleeding or intestinal necrosis.