Anomalous origin of aberrant right subclavian artery (ARSA) is a congenital anomaly where symptomatic patients require surgical intervention. It can be associated with other congenital anomalies. A 38 -year-old, woman with a 4 -year history of progressive dysphagia had bilateral cervical rib and a scalene node. She underwent surgical repair by right supraclavicular approach. She tolerated the procedure well, and was discharged home, symptom free, on postoperative day 4. This approach provides good exposure for simultaneous management of dysphagia lusoria and excision of cervical rib. (Ind J Thorac Cardiovasc Surg, 2008; 24: 32-34)