Introduction: We report a complex case of pre and post-subclavian coarctation of aorta associated with aberrant right subclavian artery and symptomatic aneurysm of the distal aortic arch. Case Report: Although CT scan of the chest had clinched the diagnosis, aortic anatomy was further elucidated on digital subtraction angiography when coronary angiogram was performed for cardiac risk stratification. Patient underwent repair of aneurysm and coarctation concurrently under profound hypothermia and total circulatory arrest. Post-op recovery was uneventful. Conclusion: Judicious use of total circulatory arrest along with tailored surgical strategy provided optimal operating conditions leading to excellent recovery.