A 1.5 year old, sexually intact male Shih-Tzu dog was presented for a one-year history of constant regurgitation after feeding. Megaesophagus and persistent left cranial vena cava (PLCVC) was diagnosed based on radiography, exploratory surgery, and autopsy. The cranial esophagus was compressed by the PLCVC and the left subclavian artery to form a dilated precardial pouch. This multiple abnormalities contributing to persistent regurgitation is very rare in the dog.