Computed tomography angiogram (CTA) with 3D reconstruction in a 2-year-old male with history of vascular ring, comprising a right circumflex aortic arch (CAA) with aberrant left subclavian artery (LSCA) and a left-sided ligamentum arteriosum (LA), status post division of LA with persistent cough and dysphagia. CAA is a rare variant of vascular rings where the transverse arch crosses the midline, posterior to the esophagus ( green ) and trachea ( blue ), and descends on the contralateral side (a). Posterior crossing of the CAA can cause significant tracheal and esophageal compression even after division of LA (b, c). Definitive surgical correction is possible with an “aortic uncrossing” procedure in which the transverse aortic arch is transected, and the retro-esophageal component is moved anteriorly and anastomosed to the ascending aorta in an end-to-side fashion. Delineation of vascular anatomy and relationship to the airway and esophagus is imperative for surgical success