Coronary malperfusion due to acute aortic dissection (AAD) is a relatively rare, but fatal condition. We experienced a case of acute myocardial infarction (AMI) with cardiogenic shock due to compression of the left main trunk (LMT) by a false lumen of an AAD. Percutaneous coronary intervention (PCI) to the LMT was firstly performed, followed by a definitive surgery under a stable hemodynamic condition. Stanford type A AAD is an indication for emergency operation and stenting to the LMT is controversial. However, it might be an essential strategy to perform precedent PCI to the LMT which quickly relieves global ischemia, and achieves hemodynamic stability for the following definitive surgery.