A timely diagnosis of aortic dissection can be lifesaving given its deadly nature. A high index of suspicion should be maintained because patient presentation can mimic other common emergency room complaints. The gold standard diagnostic test is a computed tomography angiogram from the thoracic inlet to the femoral arteries which identifies aortic dissection with excellent accuracy. Echocardiography should be used to assess aortic valve function and to evaluate for pericardial effusion. A finding of aortic dissection should prompt a thorough investigation for its sequelae including malperfusion and/or rupture which should guide further workup with appropriate laboratory and imaging studies.