Isolated spontaneous superior mesenteric artery (SMA) dissection is rare, and difficult to diagnose due to nonspecific signs and symptoms. The clinic presentations include abdominal pain, nausea, and vomiting. The incidence appears to be increasing, possibly as a result of the widespread use of computed tomography angiography (CTA) imaging for abdominal pain. There is no consensus regarding the best treatment of spontaneous isolated dissection of the SMA. Herein, we present 2 cases in which isolated superior mesenteric dissection was diagnosed by CTA. The first case received conservative treatment, and the other case received endovascular therapy. Both patients had good long-term clinical results.