Abstract: This article explores the CT findings and outcome of a case involving median arcuate ligament compression syndrome complicated with spontaneous isolated superior mesenteric artery dissection. Three-dimensional reconstruction of multi-detector spiral CT angiography can effectively display the degree of abdominal trunk stenosis, development of collateral circulation, and dynamic process of superior mesenteric artery dissection remodeling. This approach is valuable for evaluating the disease and guiding the clinical treatment.