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Acute aortic dissection is considered a potentially fatal condition. Neurologic manifestations such as paraplegia are quite rare. We report a case of acute paraplegia in a hypertensive smoker chronic obstructive lung disease patient. Transthoracic echocardiography revealed a dissection flap starting at the aortic annulus and extending to the descending thoracic aorta. Computed tomographic aortography confirmed the diagnosis with a dissection flap extended from the aortic annulus to the entire distal aorta. The patient was referred to another specialized cardiothoracic center, but unfortunately, he died during the surgery.