Pregnancy complicated with Stanford A aortic dissection is a rare complication during pregnancy, which is a severe condition with high mortality of maternal and infant. The anesthesia management in this case is difficult. This paper reports the anesthesia and surgical procedures of one case of twin pregnancy complicated with Stanford A aortic dissection to provide guidance for this kind of patient′s anesthesia management. Adequate analgesia and proper control of blood pressure should be performed on this type of patients before operation, and the anesthesia induction must be stable to avoid dissecting aneurysm rupture by rapid change of blood pressure. Intraoperative monitoring can guide the anesthesia management well and accelerate the postoperative rehabilitation such as transesophageal echocardiography (TEE), bispectral index of the electroencephalogram(BIS), regional cerebral oxygen saturation(SCO2) and so on. Multidisciplinary cooperative therapy is also an important means to improve the survival rate of mother and infant after surgery.