Objective To evaluate the applicability of Transcranial Doppler (TCD) monitoring in brain protection in the process of aortic dissection surgical procedure. Methods From Feburary 2007 to November 2007, six patients with type I aortic dissection underwent surgical procedure in Xuanwu Hospital of Capital Medical University. All patients are male with their age ranged from 48 to 60 years. During the operation, right subclavian arterial cannulation technique was used to protect the brain, and TCD monitoring was adopted to guide cerebral perfusion. The function of nervous system after operation was observed, and the minimental state examination (MMSE) was used to assess the cognitive function of the patients. A twoyear followup was done to monitor patients’ aorta condition. Results The time of cardiopulmonary bypass (CPB) was 136 to 350 minutes. The time of selected cerebral perfusion was 20 to 65 minutes. The lowest cerebral blood flow was 31% of basic level according to TCD monitoring. All patients were successfully treated without neurological complication and cognitive dysfunction when discharged from hospital. MMSE score was 28 to 30 points. During the twoyear followup after operation, all aortic false lumen were closed and there was no dissection recurrence. Conclusion Monitoring blood change with TCD monitoring technique is safe and effective in evaluating brain protection by selective cerebral perfusion in aortic dissection surgical procedure.