Background:Quite severe Quick surgical repair is necessary to prevent death in cases of aortic dissection, a cardiovascular emergency. Aim and objectives:We looked at the predictive value of preoperative D-dimer level for early postoperative death and bad outcomes in patients with acute type A aortic dissection. Patients and methods:We enrolled fifteen (15) consecutive patients in this prospective observational cross-sectional study who had symptoms of acute aortic dissection (Stanford type A) & had emergency surgical repair. Participants took part in the study at the Cardiothoracic Surgery Department at Kasr Al-Aini Hospitals, Cairo University, from May 2021 to February 2022. Results:Diseases characterized by renal, hepatic, pulmonary, or neurological dysfunction were associated with a markedly elevated D-dimer level when contrasted with healthy controls. There was a perfect match between the sensitivity and specificity of 5.35 mg/L of D-dimer for death prediction and 5.35 mg/L of placebo. Both the sensitivity and specificity for the prediction of renal failure were 100% at 4.55 mg/L and 6.10 mg/L, respectively. Conclusion:Most hospitals and clinics should have D-dimer on hand. In patients undergoing surgical repair for type A aortic dissection, our study found that higher preopermer levels were linked to an increased incidence of postoperative mortality and adverse events. Patients whose D-dimer levels are consistently high should be closely always observed.