Objective To evaluate the efficacy and value of digital subtraction angiography (DSA) and multi-slice spiral computed tomography (CT) in the diagnosis of aortic dissection. Methods Sixty-four patients with suspected aortic coarctation were selected from May 2022 to November 2024 in our hospital, and all of them were examined by DSA and CT. The diagnostic efficacy of each was analyzed by comparing the results of the two imaging tests. Results The positive rate of CT diagnosis was 85.94% (55/64), the missed diagnosis rate was 1.56% (1/64), the sensitivity and specificity were 98.21% and 100%, respectively, and there was no significant difference compared with the diagnostic results of DSA (P>0.05). The CT group had 99 (99.00%), 36 (97.30%), 37 (100.00%), and 91 (98.91%) endometrial rupture, intimal flap, true and false double lumen, and affected branches, respectively, which were consistent with the findings detected by DSA (P>0.05). The first incision size, distance from incision to LSA, and distal diameter of the true lumen measured by CT were (16.54 ± 1.69) mm, (19.12 ± 2.44) mm, and (27.92 ± 2.26) mm, respectively, which were similar to the DSA measurement results (P>0.05). Conclusions Multi slice spiral CT has high accuracy in the diagnosis of aortic dissection, and its diagnostic results are comparable to DSA. CT has the advantages of non invasiveness, reproducibility, convenient operation, and high patient acceptance