Thoracic Outlet syndrome is defined to compression of the subclavian vessels and brachial plexus at the superior aperture of the thorax. It was previously designed due to presumable etiologies such as scalenus anticus, costoclavicular, hyperabduction, cervical rib or first rib syndromes. We experienced a case of thoracic outlet syndrome[scalene anticus syndrome] .Patient has been suffered from swelling and numbness of the right forearm and hand for 2 years. Diagnosis was made by preoperative selective angiography. Scalenus anticus and medius muscle resction and first rib resection was done with transaxillary approach. Postoperative course was not eventful.