A celiomesenteric trunk (CMT) anomaly is extremely rare, occurring in less than 0.5% of people. We describe two cases of CMT anomaly treated surgically for median arcuate ligament compression with stenosis causing intestinal angina and an asymptomatic aneurysm. Disease involving a CMT is extremely uncommon. This comprises the first report of symptomatic median arcuate ligament compression of a CMT. Only four cases of aneurysmal disease are reported so far. Indications and technique of surgical repair of CMT aneurysms are similar to those used for splanchnic artery aneurysms.