A 55 year old man, hypothyroid from previous thyroidectomy, presented with angina due to tracheal compression by a tumour of the posterior superior mediastinum. The preoperative work-up was negative. An aneurysm of a retrooesophageal subclavian artery was found at exploratory right thoracotomy in January 1977. This was resected and arterial reconstruction with a dacron graft was performed. The long term post operative clinical and angiographic results are satisfactory. The medical literature of this rare condition is reviewed.

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