We present the case of a young man with traumatic aortic dissection secondary to a motor vehicle collision. While the differential diagnosis for traumatic injury after a motor vehicle collision can include commonly studied and trained for cases, such as pneumo/hemothorax, pulmonary contusion, splenic laceration, and pelvic fractures, for example, one of the more deadly and hence rare presentations of motor vehicle trauma is aortic transection. The fact that the diagnostic studies included as part of the initial Advanced Trauma Life Support® (ATLS®) trauma survey are not well equipped to diagnose such an injury is also a deadly factor. In this case review, we explore factors affecting the timely diagnosis, management, and outcomes of traumatic aortic injury. Prompt diagnosis is imperative in order to save a patient's life.