Coarctation of the abdominal aorta with stenoses or occlusions of the renal and mesenterial arteries was diagnosed in four patients. Three of the patients had severe hypertension and two had intermittent claudication. All the patients had normal arteries in the legs. The first patient was diagnosed i 1974 and was judged at that time to be inoperable. He is still alive, but suffers from severe hypertension and intermittent claudication. The other three patients were diagnosed later and have all been surgically treated, two with Dacron bypasses from the thoracic to the abdominal aorta, one of them with supplemental Dacron bypasses to both renal arteries, the celiac axis, and the superior mesenteric artery. The last patient had a Dacron prosthesis from the thoracic aorta to both common femoral arteries implanted. Post-operatively, the three patients operated on were free from symptoms and normotensive.