Abstract Objective To investigate the effect of conservative treatment and mid-term follow-up of Stanford B intermural aortic hematoma patients without calcified spots in the diseased aortic wall. METHODS We retrospectively analyzed the clinical data and regular follow-up of 21 patients with Stanford B aortic intermural hematoma without calcified spots in the diseased aortic wall diagnosed by CTA of the whole aorta performed by 64-row or above CT from March 2009 to March 2012, and the results were summarized in this study. RESULTS One patient in this group was treated with TEVAR after 1 week of drug therapy, and the remaining 20 were treated with full drug therapy and discharged asymptomatically with close imaging follow-up. There were no lost cases in 21 patients in this group, and all the follow-up patients survived. For patients with asymptomatic recurrence during the follow-up period, the aortic CTA was reviewed at 3 months, 6 months, and 1 year after the onset of symptoms, and the left pleural effusion was completely absorbed in 11 patients at the 3-month follow-up, the intermural hematoma was completely absorbed in 3 patients, the intermural hematoma was completely absorbed in a total of 13 patients at the 6-month follow-up, the intermural hematoma was completely absorbed in a total of 19 patients at the 1-year follow-up, and the remaining 2 patients were completely absorbed, and the remaining 2 patients were completely absorbed, and the remaining 2 patients were completely absorbed. At 1-year follow-up, the intermural hematoma was completely absorbed in 19 patients, and the thickness and extent of the intermural hematoma were significantly reduced in the remaining 2 patients. Conclusion: It is easy to determine whether there are calcified spots in the aortic wall of Stanford B type aortic intermural hematoma patients, and strict conservative treatment for patients without calcified spots is satisfactory and has good results in the mid-term follow-up. Zhiwei Wang, Department of Vascular Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.