A predisposing weakness of the vessel wall has been assumed in patients with spontaneous cervical artery dissections (sCAD). Skin biopsies from many patients with sCAD show mild connective tissue alterations. However, their assessment depends on an invasive and highly specialized technique. Clinical signs of connective tissue disease are absent in the majority of CAD patients. In this review we document that only very few CAD patients are affected by known inherited connective tissue disorders like Ehlers-Danlos syndrome, Marfan syndrome or Osteogenesis Imperfecta. In a second part of this review we discuss the possible role of unrecognized or unknown forms of connective tissue disorders in the etiology of CAD.