Rupture of thoracic aortic aneurysms and/or dissections is not rare, occurring in approximately 0.6% of all medicolegal autopsies. Most forensic pathologists are aware of the association between thoracic aortic aneurysms/dissections and trauma, atherosclerosis, inflammation and Marfan syndrome. In this report, we discuss a familial form of thoracic aortic dilatation and/or dissection that is distinct from Marfan syndrome. In addition, we review the topic of thoracic aortic aneurysm and dissection and encourage family notification by forensic pathologists when familial forms of aortic disease are suspected at autopsy.