An aberrant right subclavian artery is an uncommon anomaly. When associated with esophageal cancer, it can cause diagnostic confusion as the symptoms are similar. If unrecognized and injured during esophageal surgery, it can lead to disastrous complications. We report a patient in whom this aberrant artery was injured during a thoracoscopic mobilization of the esophagus. The embryological and radiologic aspects of this anomaly and its clinical significance are discussed. Pre-operative diagnosis will require a high index of suspicion, as the clinical and radiological features are not specific. If injury occurs, an immediate vascular reconstruction will prevent limb ischemia and hence knowledge of this entity is of utmost importance.