DISCUSSION: PAA is a rare condition with an incidence of 1 in 14,000 autopsies. Unlike aortic aneurysm it has equal prevalence in both genders and occurs in younger patients. The likely pathology seems to be increased hemodynamic stresses combined with underlying vessel wall weakness. It is commonly associated with congenital heart defects (shunts, PDA or VSD), pulmonary artery hypertension and connective tissue disorders such as Marfan’s syndrome and infections like syphilis and TB. It typically presents with hemoptysis, chest pain, cough and/or dyspnea but is also not infrequently discovered as an incidental finding. The advent of contrast-enhanced CT, MRI and echocardiograms have assumed a primary role in diagnosis. Complications may include pulmonary hypertension, thrombus formation, bronchial compression or aneurysmal rupture. Management is surgical coupled with treatment of the underlying disorders.