Arterial dissection is the result of blood entering along the intima-media plane through a breach produced either spontaneously or traumatically. Cervical arterial dissections are an important cause of acute ischemic stroke in children, young adults, and patients with cranio-cervical traumatic injuries. Arterial dissections occur either spontaneously, in genetic diseases, the most important association being with fibromuscular dysplasia. In most of the cases dissection involve the extracranial portions of the internal carotid and vertebral arteries. Magnetic resonance with T1 fat-saturation (T1 FS) sequence of the cervical region or computed tomography (CT) with computed tomography angiography (CTA) shows a very high sensitivity and specificity in the diagnosis of cervical artery dissections. Therapeutic options are still debatable in patients with acute ischemic stroke and vertebral or carotid artery dissection.