Isolated mesenteric artery dissection (IMAD) is not rare. Although there are five classification methods, all of them are based on imaging findings, and all have limitations. According to patient's symptoms, signs and imaging findings, the IMAD were divided into emergency and non-emergency types, and a management flow chart of IMAD is established according to this classification. The emergency type needs surgery or endovascular treatment immediately after the diagnosis, and conservative management to non-emergency patients. Majority of IMAD patients have stable disease after conservative treatment, and only a few patients with disease progression requiring invasive intervention, and endovascular stent placement should be the first choice of those patients.