The aim of this work is to study the preoperative selection of cases of acute type A aortic dissection and the different surgical modalities for management of these cases and the outcome of these surgical techniques.Patients and methods: This study was conducted on 30 consecutive patients at the Cardiac Surgery Department, Mauriziano Umberto I Hospital, Torino, Italy ,for whom surgical interference was performed for acute type “A” Aortic Dissection. They included 21 (70%) male patients and 9 (30%) female patients with a mean age of 62 ± 10.8 years.Results: The peak of incidence was in winter (January) & least incidence in summer. The most significant risk factor was hypertension [29 (96.7%) of the patients]. All patients were admitted as emergency cases, 50% of them were in critical state. The majority of these patients (66.7%) were operated for Ascending Aortic replacement solely while the rest had some kind of modification beside the ascending Aorta (valve replacement or repair, Modified Bentall De Bano, or hemiarch replacement). The mean bypass time was 187.1 ± 60.9 minutes, with mean Aortic cross clamp time of 96.8 ± 36.7 minutes and total circulatory arrest time of 26.8 ± 10 minutes and mean temperature of arrest 20.1 ± 2.5 ˚C. The mean ICU stay was 4.66 ± 3.7 days. The mean hospital stay was 11.3 ± 1.4 days with overall mortality of 30% after 24 months of follow up.Conclusion: Early Diagnosis of Acute type “A” Aortic Dissection is empirical for less complications & better operative & post-operative results