Chronic aortic dissection is one of the most challenging pathologies faced by aortic surgeons. The variety of presentations and the multiple comorbidities of the patients make treatment and follow-up a subject of much debate. Historical data is difficult to interpret because of the heterogeneity of the included populations, and the common tendency of authors to pool outcomes of thoracoabdominal aortic aneurysm repair secondary to degenerative pathology or connective tissue disorder with those who have an underlying dissection. As the endovascular treatment of chronic aortic dissection becomes more commonplace with the increasing use of branched and fenestrated technology, it will be important to have an historical “gold standard” to use as a comparator. This narrative review of the literature describes the challenges to interpretation of data and the available information published about chronic aortic dissection.