We report about one case of acute dissection of the infrarenal abdominal aorta associated with a horseshoe kidney. A few points in the history of this 47-year-old patient deserve being underscored: the absence of an "etiological" factor of aortic dissection, the presence of five renal arteries, illustrating the complex vascularity of a horseshoe kidney, the specific surgical problems arising from both a lesion of the aortic junction and a horseshoe kidney. On the basis of the literature, we underline the incidence of dissection of the infrarenal aorta (1 to 3%), that of horseshoe kidney (0.15%) and that of pathology of the aortic junction in patients with a horseshoe kidney, which seems to be accidental.