Celiac artery compression syndrome and superior mesenteric artery syndrome are two rare diseases, extensively documented in the literature, with a pathogenesis which is still controversial. Their association never been carefully studied and only one such case has been reported. For this reason we reviewed our experience from january 1974 to december 2000, including 57 patients diagnosed with coeliac artery compression syndrome and 27 patients with superior mesenteric artery syndrome. We found the presence of both syndromes in 6 patients. All 6 were submitted successfully to a duodeno-jejunal bypass and decompression of the coeliac artery. In this paper we analyse the pathogenesis, clinical presentation, diagnosis and treatment of these syndromes emphasising their common aspects. The association of the coeliac artery compression syndrome and superior mesenteric artery syndrome has never been thoroughly studied because of their rarity. The lack of recognition of this association may, in some cases, justify the controversial results reported in the surgical treatment of these syndromes.