Abstract
Renal artery compression due to a diaphragmatic crus is a rare cause of secondary hypertension. This is usually a combination of a high origin of the renal artery and a prominent diaphragmatic crus leading to its compression similar as the median arcuate syndrome. We report a case of a 31-year-old male with uncontrolled hypertension despite four antihypertensive medications. A surgical decompression associated with direct reimplantation of the left renal artery was performed. The outcomes were uneventful with early discharge and immediate postoperative discontinuation of his antihypertensive medications up to 3-year follow-up.