The investigators describe an unusual case of tracheal and esophageal compression by atherosclerotic dilatation of the diverticulum of Kommerell associated with a congenital aberrant right subclavian artery, illustrating how aging-related vascular degenerative disease can modify the clinical manifestations of congenital anomalies in an 84-year-old man. In conclusion, the potential interactions between congenital and acquired cardiovascular disease should be considered in the evaluation of cardiovascular symptoms in the elderly population.