Middle aortic syndrome is a rare condition characterized by segmental narrowing of descending thoracic aorta or abdominal aorta. It is either congenital or produced by a number of acquired etiologies. The condition may cause severe hypertension and most of the patients if left untreated would die by 40 years of age. A 12 year old girl presented with severe hypertension secondary to discrete mid - thoracic aortic coarctation. We present the surgical technique employed and discuss other modalities of treatment.