?  The median arcuate ligament syndrome (MALS, also known as celiac artery compression syndrome, celiac axis syndrome, celiac trunk compression syndrome or Dunbar syndrome) is a condition characterized by abdominal pain attributed to compression of the celiac artery and possibly the celiac ganglia by the median arcuate ligament.^[1] This is a case of a A 35/F was admitted with complaints of  epigastric pain Postprandial fullness Weight loss of ~10 kgs in 6 months , occasional emesis and anorexia .CT angiography with Digital Subtraction shows  focal narrowing of the proximal celiac artery with poststenotic dilatation and indentation on the superior aspect of the celiac artery and a hook–shaped contour of the celiac artery supporting a diagnosis of MALS. A fibrous band of Median Arcuate  Ligament was found to compress the  Coeliac trunk, which was idenified and cut released. Median Arcute Ligament syndrome is a difficult diagnosis to arrive at, in a majority of patients. A patient with suspected compression of the coeliac artery should undergo mesenteric ultrasound with evaluation of the arterial velocity.Patients who have evidence of median arcuate ligament syndrome should undergo surgical decompression; which can be done via open traditional method or minimal invasive methods.