Introduction: Right sided aortic arch is a rare condition (1:1000 persons) in the setting of an otherwise normal heart and it is an anatomic variant resulting from the persistence of the right fourth aortic arch and involution of the left. Half of cases are associated with an aberrant left subclavian artery that can become aneurysmal (Kommerell´s diverticulum). On account of the propensity to cause symptoms and the possibility of lethal rupture, surgery is often indicated, despite the absence of clear criteria for repair due to the rarity of this finding. Fewer than 50 cases have been reported in literature and a number of operative strategies are described, mainly by left subclavian-to-carotid transposition (subclavian revascularization) and subsequent aneurysm approach, through right thoracotomy. Those are, however, associated to significant morbidity. Methods: This is a case-report of a patient who was referred to a vascular department of a tertiary hospital with an incidentally finding of a right sided aortic arch with Kommerell diverticulum of the aberrant left subclavian artery. Results: The patient was a 51-year-old female with a prior history of hypertension, cervical herniated disc requiring surgery and hysterectomy. She was referred for assessment of vascular anomaly that was found incidentally in an image study. The angio CT showed a right aortic arch with a Kommerell diverticulum with a maximum diameter of 30mm, with mild esophageal compression but no associated symptoms. Pondering the aneurysm size, the need for a cervical approach for the cervical herniated disc and the mild esophageal compression, in a patient with low operatory risk, hybrid operation was planned. A left carotid-subclavian bypass with ligation of the aberrant left subclavian artery was performed. Subsequently, anterograde flow into the aneurysm was excluded by implant of a thoracic endograft and a vascular plug (Amplatzer II) was implanted in the distal segment of the diverticulum. There were no perioperative complications and patient was discharged 3 days later. The follow up CT showed a patent carotid-subclavian bypass and complete aneurysm exclusion. Image subtitle: A- Pre op B- Post op (white arrow: Kommerell Diverticulum) Conclusion: A hybrid approach may offer an effective and less invasive option for aneurysms resulting from an aberrant subclavian artery origin. Long term outcomes are not yet established and cautious follow up is recommended.