We report a 47-year-old man who presented with acute right leg pain without any other symptoms on visit to ER. But he had the severe back pain when the leg pain developed. Contrast CT revealed no enhancement on right common iliac artery and aortic dissection from the lower level of right renal artery to the iliac artery bifurcation. Angiographic stent insertion was performed immediately, but the patient showed reperfusion syndrome and died after 3 days. Aortic dissection with the isolated peripheral vascular complications is rare. Aortic dissection should be included in the differential diagnosis of patients with acute lower leg ischemia like peripheral arterial occlusive disease.