Aneurysms of the upper extremities, and particularly the intrathoracic segment of the subclavian artery, are unusual. Surgical approach and timing of repair remain controversial. We successfully treated a case of a large proximal subclavian artery aneurysm, atherosclerotic in origin. In spite of the size, the symptoms were vague. The patient underwent partial resection of the lesion located in the proximal third of the right subclavian artery, and repair using 8 mm dacron interposition graft. She did well postoperatively and remains symptom free at 1 year. A discussion of this disorder with the relevant literature review is herein included.