The presence of congenital tracheobronchial abnormalities remain rare and have been reported to range from 0.1% to 2% in the literature. The most commonly described abnormalities are the tracheal bronchus and the accessory cardiac bronchus. We present the case of a 67-year-old man presenting for evaluation of interstitial lung disease, on computed tomography found to have presence of both the anomalies; the findings later confirmed on bronchoscopy. We believe this report is important as it adds more descriptive information regarding this unusual presentation, including bronchoscopic and computed tomographic images. We believe that it is imperative that bronchoscopists are cognizant of these congenital abnormalities and their combinations. Inability to properly characterize these abnormalities has a potential leading to unnecessary investigations of these relatively benign entities.