Abstract A 32-year-old female patient presented with recurrent and protracted hemoptysis. Computer tomography scan demonstrated inflammation in left lower lobe, dilation in the lower thoracic esophageal and a right aortic arch. Consequently, a gastroscopy was suggested by the local hospital and an esophageal diverticulum was detected; however an incidental esophageal fistula from the diverticula interrupted the diagnostic process. Accordingly, a nasogastric feeding tube was recommended by the neighbouring hospital and utilized for six months, during which her syndrome deteriorated. In her latest visit, VR imaging revealed an aberrant artery supplying the left lower lobe, ultimately suggesting the diagnosis of pulmonary sequestration. A uniportal video-assisted thoracoscopic surgery was conducted with the assistance of gastroscopy. Upon identification of the anomalous artery, the lung was inflated to delineate the lesion boundary. This artery and the lesion it supplied was corresponded with VR imaging, thereby a definitive resection was performed. Postoperatively, the patient was followed up for six months, revealing significant relief of hemoptysis. The triad of anomalies that a right aortic arch, esophageal diverticula, and pulmonary sequestration, plaguing the patient for three years, was eventually identified.