Acute aortic dissection (AAD) is a very dangerous cardiovascular emergency. Although some progress has been made in diagnosis and treatment, the mortality rate of AAD is still high. AAD is a multi-factor involved disease, and its pathophysiological mechanism has not been fully explained, so its clinical treatment effect is limited and its mortality rate is extremely high. A large number of studies have shown that serum amyloid A (SAA), as a major inflammatory protein produced in the acute phase response, is closely related to the occurrence and development of cardiovascular diseases.Therefore, SAA may become a candidate target for the diagnosis and treatment of AAD. This review discusses the relationship between SAA and inflammatory response, vascular dysfunction, thrombosis and extracellular matrix remodeling, and the possibility of SAA as a potential biomarker of AAD.