Acute aortic dissection can occur in pregnancy in association with severe hypertension due to preeclampsia, coarctation of the aorta, or connective tissue diseases such as Marfan syndrome. The aims of anesthesia are to minimize fetal exposure to cardiopulmonary depressant drugs prior to delivery while ensuring a well-controlled hemodynamic environment for the mother. We encountered a case of a 31-year-old pregnant woman (gestational age 38 weeks) with preeclampsia, gestational DM, and acute aortic dissection (Stanford type A, DeBakey type II). The patient successfully underwent an emergency cesarean section and the subsequent repair of the aortic dissection under general anesthesia. We report this experience with a brief review of the relevant literature.