Our understanding of carotid artery dissections has substantially increased over the past decade. We now know much more about the pathophysiology, imaging appearance, and medical and interventional management of dissections. Still, many radiologists remain unaware of the changing landscape in this field. This article set out to highlight the most up-to-date information about this pathology with a focus on the CT and MR imaging characteristics, new imaging frontiers, and treatment options for dissections.