While single nucleotide polymorphisms (SNP) have been extensively researched in atherosclerotic aortic aneurysms, there are too few data about acute aortic dissection (AAD). The matrix metalloproteinase regulation system has shown a high biological relevance to the development of aortic aneurysms and AAD. The TIMP-1 c.T372C (rs4898, nt+434) SNP was previously associated with the onset of abdominal aortic and other aneurysms. Therefore, we chose this SNP to search for a connection with AAD and to find its place among the other risk factors. 115 patients with AAD were studied for their TIMP-1 c.T372C genotype by means of conventional restrictase analysis. To confirm the biological relevance of our findings, immunohistochemistry for TIMP-1 was performed on tissue samples from the same patients with AAD and compared with a control group of 23 autopsy cases. The TIMP-1 c.T372C showed a significant difference in allele frequency in the AAD patients compared to the general population (p < 0.0001 for both sexes). This genotype did not show any association with any other co-morbid condition, nor with age. The immunohistochemistry results also showed significantly lower TIMP-1 expression in the dissected aortas. The C allele of TIMP-1 c.T372C shows a strong association with the onset of AAD.