Median arcuate ligament syndrome is considered as rare syndrome manifested by variety of symptoms. Aim of the Work: To assess the presence of asymptomatic patients showing the typical color duplex ultrasound and CT angiographic features of MAL syndrome and the impact of these findings on the pathogenesis and management of the syndrome. Material and Methods: 200 asymptomatic patients were examined with color duplex ultrasound and further CT angiography was performed to all patients with color duplex findings of arcuate ligament syndrome. Results: 8 patients showed typical color duplex findings and CT angiographic features of MALS. Conclusion: The diagnosis of MAL syndrome shouldn't depend only on the imaging criteria and should be strongly linked to the unexplained patient symptoms after meticulous exclusion of other etiologies. The management shouldn’t depend only on relieving the arterial stenosis but also on dissection of peri arterial nerve plexus.

arcuate ligament, color duplex sonography, computed tomographic angiography, asymptomatic