A 42-year-old female was admitted to our hospital for abnormal shadow in the left superior mediastinum on chest X-ray. Her blood pressure was 120/70 mmHg in the left arm and 134/72 in the right. Aortography revealed pseudocoarctation of the aortic arch distal to the left carotid artery with two aneurysm, and showed elongation between the left carotid artery and the left subclavian artery. Aneurysmectomy and graft replacement using a woven Dacron graft were successfully performed under cardio-pulmonary bypass. In 1969, Gay et al reported a case of pseudocoarctation which led to a fatal rupture of the thoracic aorta, so we recommend surgical therapy in cases of pseudocoarctation associated with aneurysm formation.

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