¹Department of Cardiovascular Surgery, Yüzüncü Yıl University Faculty of Medicine, Van DOI : 10.9739/uvcd.2013-37068 Acute aortic dissection is a fatal disease which needs to be evaluated and treated imme- diately. Patients often have sudden-onset of severe chest pain radiating to the back, but sometimes aty- pical symptoms can also be seen. Early recognition of the clinical manifestations, rapid confirmation of the disease by using imaging modalities, urgent administration of appropriate medication and ap- propriate selection of long-term therapy are the main key points to save the patient"s life and reduce morbidity. In recent years, it has become increasingly clear that there is a relation between cocaine and aortic dissection. No single laboratory test, historical feature, or physical finding can safely rule out acute aortic dissection. Optimal management hinges on aggressive controlling blood pressure and heart rate, avoidance from using anticoagulation, and timely surgical consultation. Keywords : Dissection; cocaine; emergency treatment