Coronary artery dissection results from a tear in the inner layer of the artery, the tunica intima. This allows blood to penetrate and then to form an intramural hematoma in the central layer, the tunica media, and a restriction in the size of lumen. If the diagnosis and treatment is not prompt, the coronary artery may develop a tear, causing blood to flow between the 2 layers which forces them apart. And then the dissection may result in rupture of coronary artery, which in turn causes myocardial infarction, cardiogenic shock, and even sudden death. In this paper, we reviewed the genesis, imaging diagnosis and treatment strategies of this disorder.