Takayasu arteritis also known as pulseless disease is an inflammatory and stenotic disease of medium and large sized arteries characterized by a strong predilection for the aortic arch and its branches. However, it is rarely reported as a cause of middle aortic syndrome. Middle aortic syndrome is characterized by localized or extended narrowing of the descending thoracic or abdominal aorta. Hypertension proximal to the aortic stenosis and relative hypotension distal to it, are characteristic findings in middle aortic syndrome. We present a case of 24-year-old hypertensive male, who presented with abdominal pain, decreased urine output and lower limb claudication, found to have involvement of abdominal aorta, visceral, renal and lower limb arteries on imaging. Though it is a rare cause of hypertension, a high index of suspicion is necessary for diagnosis and early treatment.

Keywords: Hypertension, Middle aortic syndrome, Takayasu arteritis