Thoracic outlet syndrome refers to a group of syndromes caused by compression of neurovascular structures in the thoracic outlet.1 This paper will review all aspects of one of these conditions – arterial thoracic outlet syndrome (TOS). Arterial TOS is caused by anatomic abnormalities resulting in compression of the subclavian, or less commonly, the axillary artery. Patients are typically asymptomatic and are unaware of this condition until they present with signs and symptoms of either acute or chronic upper extremity ischemia unless they have associated neurogenic symptoms that make them present sooner. The incidence of combined arterial and neurogenic TOS are not truly known, sometimes the arterial symptoms are ignored or overlooked attributing symptoms to neurogenic TOS only 2,3. Attention to history and physical are of paramount importance.

In this review article, we review all the key aspects of arterial TOS including epidemiology, anatomy, pathophysiology, progression of disease, diagnosis, and management.