Seven patients with vascular ring have been operated upon since 1965 at the Keio University Hospital with one operative death and three late deaths. Four patients had double aortic arch and 3 had right aortic arch with left ductus arteriosus. The lesser arch was divided in the four cases of double aortic arch. Ductus or ligamentum was divided in the three cases of right aortic arch with left ductus arteriosus or ligamentum arteriosum. Respiratory distress seems to constitute major cause of post-operative death and complete relief from respiratory and swallowing difficulties was achieved in only two out of the seven cases. Associated anomalies of the face and nasolaryngeal regions with vascular ring were found in three of the 6 infants. Postoperative results seemed to be less satisfactory in those with these associated anomalies. A proposal is made to call such association as vascular ring-facial syndrome.