Objective: To investigate the ultrasound findings of aortic dissection and its causes of misdiagnosis and miss-diagnosis. Methods: A retrospective analysis was conducted in 50 cases of aortic dissection confirmed by surgery or autopsy. Results: Totally 36 ascending aortic dissections, 29 aortic arch dissections, and 43 descending aortic dissections were confirmed by surgery. Echocardiography missed 16 of the descending aortic lesions, 9 of the aortic arch lesions, and 1 of the ascending aortic lesions. Misdiagnosis resulted in incorrect Debakey typing of the aortic dissection. Among them, 16 cases were misdiagnosed with type I dissection and 1 case was misdiagnosed with type III dissection. ?Conclusion: The number of missed diagnosis of aortic dissection is descending aorta, aortic arch, and ascending aorta in order from high to low. The misdiagnosis and miss-diagnosisof aortic dissection may be related to the experienceof sonographer, ultrasound image and ultrasound equipment.