ObjectiveTo investigate the clinical manifestation and pathological characteristics in the elderly ascending aortic dissection as well as the correlation between them.The cause of this disease and the pathologensis were also discussed. MethodsThe studies of the five elderly cases autopsy, clinical manifestations, pathological findings, histochemistry, and immunohistochemistry were done in the ascending aortic dissection tissues section. ResultsThe clinical manifestations of ascending aortic dissection in the elderly were complicated. The deteted results showed the retrograde degneration of smooth muscle cell in ascending aortic dissection wall and the reduction and fragmention of elastic fibers and fiberosis of collagen, and so on. ConclusionsAscending aortic dissection is a sort of blood vessel diseases seriously threatening the life of elder people. The diagnosis should be made by the combination of clinical manifestation with pathological findings in MRI and other examination methods.