Aortic dissection is a medical and/or surgical emergency that is usually catastrophic if not diagnosed and treated promptly. Transesophageal Doppler echography provides an accurate method of diagnosing and evaluating dissection of aortic aneurysm. Due to the high resolution of transesophageal echocardiography, special subtypes of aortic dissection such as intramural hemorrhage can be diagnosed. The purpose of this paper is to report a case and review the anatomical, clinical and transesophageal echocardiography aspects of aortic dissection without intimal rupture (intramural hematoma).