This study conducts hemodynamic simulations for a total of 20 patients with Type B aortic intramural hematoma (TBIMH) and aims to develop hemodynamic criteria for possible development of intimal tear and indicator for tearing location. The patients are divided into Group A without intimal tear and Group B with progression into tear. The mean oscillatory shear index OSI is calculated based on the wall shear stress (W SS) distribution. The blood pressure drop along the main aortic vessel is calculated and the high pressure drop time fraction over one cardiac cycle Td ∕T is determined, with high pressure drop being defined as the pressure drop larger than half the maximal value. By combining OSI and Td ∕T at low heart rates 60bpm and 75bpm, we reveal statistically significant correlation between no progression to tear and both low OSI < 0.121 and low Td ∕T < 0.067, with a pvalue of p = 8.7e − 5. We also propose a new parameter, namely the magnitude of tangential pressure gradient at aortic wall |∇_τp| at the time when the pressure drop is maximal during one cardiac cycle. Comparison with CT imaging reveals that nine out of ten patients in Group B develop intimal tear at the location with elevated |∇τ p|. Therefore, the current study provides a two-step procedure for the hemodynamic diagnosis of TBIMH. First, by combining OSI and Td ∕T those patients with low risk of intimal tear can be excluded. Then, the location of elevated |∇τ p| can be adopted as the indicator for possible intimal tear locations.