Abstract: AIM To investigate risk factors, clinical manifestations, complications, diagnosis, treatments and outcomes in patients with acute aortic dissection (AAD). METHODS The present investigation retrospectively analyzed clinical materials of 198 patients with AAD and clinical features between patients with type A AAD (A-AAD) and type B AAD (B-AAD) were compared. RESULTS The male-to-female ratio was 3.5∶1 in patients with AAD. 71.7% of patients with AAD had a history of hypertension. Chest pain existed in 81.3% of patients with AAD. The proportion of patients with A-AAD who had concomitant acute myocardial infarction was significantly higher than patients with B-AAD (35% vs. 12 %, P<0.01). The transthoracic echocardiography had greater value in the detection of A-AAD than B-AAD (36% vs. 8%, P<0.01). The overall in-hospital mortality of patients with A-AAD was significantly increased when compared with patients with B-AAD (20% vs. 1%, P<0.01). CONCLUSION Males had greater prevalence of AAD and ages showed normal distribution. Hypertension was the most common risk factor of AAD. Although clinical manifestations of AAD were complicated, chest pain was the most common symptom. Patients with A-AAD were more likely to have concomitant acute myocardial infarction. The transthoracic echocardiography could be regarded as the prior method for the detection of A-AAD. There were discrepancies among treatments and outcomes between patients with A-AAD and patients with B-AAD.