Use of molecular tools to diagnose and treat aortic disease, in particular, aortic aneurysms and aortic dissections, is still in its infancy, with great advancements expected in the future. Currently under investigation are the genetic markers linked to aortic disease that may help to identify patients at risk for their development prior to clinical presentation. In addition, specific gene defects may be identified that can assist in the understanding of the basic mechanisms contributing to development of aortic disease. Biomarkers are under investigation that can be used to monitor the development, progression, and possible response to therapy for aortic aneurysms and acute aortic syndromes. Equally important, further investigations into the molecular mechanisms involved in aortic pathology will result in increased understanding of the disease etiology and will lead to development of alternate therapies for these diseases prior to their catastrophic development. With advances in molecular technology, the molecular diagnosis and treatment of aortic diseases will begin to expand at a rapid rate and provide unique, improved therapies.