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Abstract Background Aortic dissection is a life-threatening syndrome that sometimes requires emergency intervention, and endovascular aortic aneurysm repair (EVAR) is a treatment option. Long-term image follow-up is also required for patients after EVAR due to possible complications. Case presentation We present the case of a 73-year-old male with underlying chronic renal disease diagnosed with a type A aortic dissection who underwent EVAR. Four-dimensional (three spatial dimensions combined with time) phase-contrast magnetic resonance imaging (4D PC-MRI) was performed during regular follow-up in preference to contrast-enhanced computed tomography or simple MRI while taking his poor renal function into consideration. Conclusions We considered this preferable given his issues with renal function.