Aortic coarctation type B refers to coarctation of the descending aorta originating from the distal left subclavian region, often accompanied by intermural hematoma formation. The first choice of treatment is conservative treatment with internal medicine, followed by surgery when the condition is slightly stabilized. Type B aortic coarctation should first control blood pressure and heart rate with drugs, preferred intravenous application of sodium nitroprusside, to rapidly reduce blood pressure and prevent the extension of intermural hematoma, and other antihypertensive drugs can be applied jointly if necessary. It is also necessary to apply β-blockers (such as bisoprolol, etc.) to control the heart rate and prevent further progress of the sandwich. After the blood pressure and heart rate are controlled and stabilized, endovascular luminal repair is performed on a limited schedule. If hypertension is not well controlled under medical treatment, pain persists without relief, and the patient shows signs of aortic dissection or acute lower limb ischemia or renal ischemia, the patient should undergo endovascular repair as an emergency immediately, or other appropriate surgical procedures may be chosen according to the specific condition. Aortic coarctation is a critical emergency and has a high mortality rate if not treated in time, so once diagnosed, it should be treated aggressively.