Acute aortic syndrome (AAS) is the unique name for aortic dissection, intramural hematoma, and penetrating aortic ulcer. The syndrome is manifested in patients with sudden, strong, and sharp chest pain that spreads to the back. The clinical picture is not sufficient to distinguish these conditions without detailed radiological imaging. Presentation of the site of damage to the aorta affects the further course of treatment, surgical or endovascular. Methods of choice in diagnosis are transesophageal echocardiography (TEE), computed tomography (CT), and magnetic resonance imaging (MRI). CT and MRI provide a good view of the entire thoracic and abdominal aorta and have great accuracy in diagnosing AAS. Since it is an acute condition, the advantage of CT is emphasized due to the speed of the procedure, but also its wide availability. It should be noted that an MRI does not use ionizing radiation or iodine contrast agents. The most important role of TEE is in hemodynamically unstable patients. Other diagnostic methods include chest radiograph and transthoracic echocardiogram (TTE). Due to the high frequency, the acute coronary syndrome should be suspected in patients with chest pain, and initial approach includes an electrocardiogram (ECG), troponin, and D-dimers.