Aim To investigate the diagnostic value of 64-MSCT angiography （64-MSCTA）for penetrating atherosclerotic aortic ulcer（PAU）. Methods 64-MSCT angiography study was performed in 14 patients with penetrating atherosclerotic aortic ulcer. The volume data was transferred to workstation for image post-processing including MPR, CPR, MIP and VR. Results The location,size ,number,depth and complications of PAU in all patients were satisfactorily showed on Axial view and MPR image. The complications of PAU included intramural hematoma，pseudoaneurysm or aortic rupture. The whole aorta outline, ulcer shape and calcified plaque of 14 patients were 3D demonstrated well on MIP and VR image. Conclusion MDCTA is accurate, fast and effective for the diagnosis of PAU.