Orgasmic headache, defined as an explosive headache occurring during orgasm, is most frequently a primary headache disorder. However, a number of conditions such as stroke (ischemic or hemorrhagic) and reversible segmental vasoconstriction may be associated with orgasmic headache. We report a 35-year-old patient with an episode of severe orgasmic headache who were diagnosed as anterior cerebral artery dissection on CT and conventional angiography.