Aortic intramural hematoma (IMH) has become accepted as a variant form of classic aortic dissection. In contrast to classic dissection, IMH is characterized by hematoma within the wall of the aorta, which gives the aortic wall an appearance of focal thickening without a demonstrable intimal flap. IMH is classified as either involving (type A) or not involving (type B) the ascending aorta. The diagnosis of IMH mainly depends upon physician recognition of the disease. However, few articles about IMH1 have appeared in China. Here we report a case of IMH in a 49 year-old man and review the relevant literature.