Background: Recently, new concepts have been developed for the diagnosis, classification, and treatment of aortic dissection. The purpose of this article is to explain the current state of knowledge on this topic and discuss related topics. New data on the etiology of aortic dissection focus on excision surgery, biomarkers, and 4D magnetic resonance imaging. A new stage of aortic division (TEM, STS / SVS) has been proposed. Finally, the latest advances in treatment options for aortic dissection were presented. For example, the frozen elephant trunk, intravascular correction of the thorax, and the concept of Endo-Bentall as a discovery of future options. Conclusion: The International Registry of Acute Aortic Dissection confirms that patient selection plays an important role in determining the outcome of surgery in patients with severe aortic dissection. Knowledge of the important risk factors for active mortality may contribute to better management and more detailed risk assessment of patients with severe aortic dissection.