This chapter is meant to give a comprehensive review of surgery for type A aortic dissection. In this chapter, we discuss the history of aortic dissection surgery, classification of aortic dissection, the presentation and diagnosis as well as technical details of cannulation strategy and aortic reconstruction after type A aortic dissection. Initial management and patient selection are two important aspects of surgical care for these patients which are covered in detail. We dedicate sections to discussing nuances of the management of the aortic arch and root as well as cerebral protection and cannulation strategies. Our hope is to provide a detailed but not overwhelming review of surgical care for patients who suffer from type A aortic dissection.