•Giant-cell arteritis-related aortic dissection occurs earlier in patients with aortitis than in those without.•70% of patients presented Stanford type A aortic dissection.•Half of patients with type a dissection had a previous thoracic aorta dilation.•Aortic surgery is the single predictive factor for survival in patients with GCA-related aortic dissection. To describe characteristics and outcomes of patients with giant cell arteritis (GCA)-related aortic dissection. We retrospectively included, through a nationwide GCA network, all patients who had an aortic dissection either revealing GCA or occurring during follow-up. A total of 46 patients were included in this study. Aortic dissection was inaugural and led to GCA diagnosis in 21 patients, whereas it occurred during follow-up in the 25 others, at a median of 53 1–265 months after GCA diagnosis. Large-vessel vasculitis (LVV) was diagnosed through imaging before or at the time of aortic dissection in 31 (67%) patients. In patients who developed an aortic dissection during follow-up, the aortic event occurred 22 1–143 months post GCA diagnosis in the patients with previous aortitis, whereas it occurred after 72 19–265 months in patients without previously diagnosed aortitis (p = 0.005). Aortic surgery was performed in 27 (59%) patients and 23 of them survived. A total of 15 (32%) patients died following the aortic dissection, including 11 who were not operated on. In a multivariate analysis, aortic surgery was the single predictor of survival (HR: 4.3; 95% CI: 1.47— 15.7; p = 0.007). Patients with prior LVV are more prone to develop early aortic dissection and require close monitoring of aortic morphology. One third of patients died from the aortic dissection. Surgery remains the best predictive factor for survival.