Introduction: Familial thoracic aortic aneurysm/dissection (TAAD) is a potentially lethal condition with a rising incidence which displays familial clustering in more than 20% of cases. Familial TAAD (FTAAD) refers to patients who have TAAD with a family history of aneurysmal disease who do not meet strict criteria for known connective tissue diseases. The FTAAD generally presents at an earlier age and has faster rate of aortic expansion. Case Report: A 45-year-old male was presented to the emergency department with acute neck and chest pain. Computed tomography detected an aortic root aneurysm and type one aortic dissection. His brother reported an aortic dissection at age 55 and his uncle succumbed to sudden death in his fifties. Conclusion: Family history may yield important clues to a catastrophic diagnosis for the acute care clinician and prompt primary care providers to discuss issues of possible screening during office visits. Most TAADs are sporadic and occur in association with atherosclerosis in older patients compared to familial TAAD, which has a mean age of 56.8. Up to 50% of susceptible relatives develop aortic dissection in FTAAD cases.