Abstract    Introduction: The term acute aortic syndrome (AAS) refers to a spectrum of life-threatening aortic emergencies^. Nontraumatic entities such as aortic dissection, intramural hematoma (IMH), penetrating atherosclerotic ulcer, impending rupture and rupture of the aneurysm constitute acute aortic syndrome. Aims and Objectives: To Study of the Incidence of Various Acute Aortic Pathologies in South Indian Population by MDCT. Methodology: Prospective Study, The study included patients referred to the Department of Radiodiagnosis, Sri Ramachandra Medical College during April 2012 to September 2014 for a CT scan with Clinical suspicion of Acute Aortic Syndrome, Known case of aortic pathology with fresh complaints, All age group were included into study while , Post-grafting / Procedures Follow up cases of acute aortic syndromes Those in whom intravenous contrast studies could not be performed were excluded from study. Result: As per the impression of MDCT the most common pathology was Isolated Aneurysm 51.61%; followed by Isolated Dissection 20.97% ; Aneurysm + Dissection 8.06%; Aneurysm + Intramural Hematoma 8.06% ; Intramural Hematoma + PAU + Aneurysm 4.84% ; PAU 3.23%. The most common impression of Dull aching Chest Pain by MDCT was Aneurysm followed by Acute Chest Pain was Aneurysm; Radiating to the Back pain was Aortic Dissection; Breathlessness was Aneurysm; Chest Tightness Aneurysm; Acute Abdominal Pain Aneurysm. Conclusion: With the help of the multi planar and volume rendering techniques, we were able to classify and sub classify the various aortic pathologies. The incidence of acute aortic syndromes in our study were clinically aneurysms presenting with acute symptoms followed by aortic dissection, intramural hematoma and penetrating atheromatous ulcers.