We present the clinical case of a patient with vascular compression of the duodenum or superior mesenteric artery compression syndrome.A female, 42 years old, with history of two months' evolution characterized by postprandial epigastric colic, without irradiation, accompanied by nausea and intractable vomiting, weight loss and gastric shaking. A double contrast gastric duodenum x-ray showed the duodenal frame with exaggerated dilatation and stenosis close to the Treitz angle, through which the contrast media barely flowed. The endoscopy revealed duodenal obstruction, gastric retention and erosive esophagitis. The computerized tomography identified a significant dilatation of the duodenal arc, with stenosis on the aorto-mesenteric junction. We performed an exploratory laparotomy, making a latero-lateral duodenojejunal trans-mesocolic anastomosis. Satisfactory evolution and discharge without complications.