Genetic aortic and vascular conditions, also known as heritable thoracic aortic disease (HTAD) are autosomal dominant conditions characterized by occurrence of aortic events, mainly aneurysms and dissections. It is crucial to be able to identify patients with these conditions as often, there are no signs until a major vascular event occurs. Once a patient with HTAD is identified, screening of their family members is critical due to the 50% chance of inheritance. Hypertension is known as the “silent killer” and the same is true for genetic aortic and vascular conditions as they can go undetected for a long time and lead to serious, sometimes fatal, health consequences. This course will provide a review of the anatomy of the aorta, discuss complications of dissection, when to suspect heritable thoracic aortic disease, how to obtain genetic testing, where to refer patients, what imaging to order, best medical management and when surgical intervention is necessary.