The occurrence of arterial dissection (AD) is the result of multiple factors. Wall shear force (WSS), an important initiating factor for AD, is the friction between blood flow and vessel wall. Abnormal WSS can cause pathological changes of arterial wall (intima, media, adventitia) through various mechanisms, such as endothelial cell structure and dysfunction, internal elastic lamina injury, reduction and phenotypic transformation of smooth muscle cells, extracellular matrix degradation, and eventually lead to the occurrence of AD. In order to better understand the pathogenesis of AD, this article reviews the regulatory mechanisms of pathological changes in each layer of arterial wall caused by abnormal WSS.