We report a rare case with severe intestinal ischemia due to chronic aortic dissection. A 75-year-old man was admitted to our hospital with abdominal and right leg pain. The patient had a history of aortic dissection (Stanford type B) 12 years before admission and had been treated medically. Although a throaco-abdominal aneurysm due to aortic dissection (Crowford type III) had been diagnosed 1 year before admission, he had rejected the operation. Computed tomography (CT) revealed an increased diameter of the aneurysm (6 cm). As abdominal pain was increased, emergent surgery was performed on day 1 after admission. Although perfusion of the superior mesenteric artery and marginal artery was maintained, intestinal ischemia was worsening and general condition was deteriorated during surgery. Bypass surgery and/or resection of colon were not indicated because of peripheral colon artery ischemia, and he expired day 1 after surgery.