Spontaneous coronary artery dissection (SCAD), is a rare but increasingly recognized cause of acute coronary syndrome (ACS). SCAD affects predominantly younger women who may lack traditional cardiovascular risk factors, posing unique diagnostic and therapeutic challenges. Recent advancements in imaging techniques and conservative management strategies have led to significant improvements in patient outcomes. This review highlights current understandings of SCAD, focusing on clinical presentation, diagnostic modalities, therapeutic approaches, and long term patient outcomes. Additionally, we explore future research directions for this rare condition.