We reported a 59 years old male presented with severe agonizing abdominal pain just to the left side of the umbilicus and referred to the left shoulder. The patient was hypertensive on bisoprolol but no history of acute coronary syndrome. He was misdiagnosed at a primary health care 5 days before diagnosis. When presented he was hemodynamically stable with blood pressure 130/80. On abdominal examination mildly tender oblong mass was felt to the side of the umbilicus. The ECG examination was irrelevant. On gray scale abdominal ultrasonographgy a double channel abdominal aorta was seen that was later confirmed by Doppler study. CT angiography showed large intimal dissection sparing the aortic arch distal to the left subclavian artery and extends all through the descending thoracic and abdominal aorta till the bifurcation with small extension to the left common iliac artery.