Ortner's syndrome, also known as the cardiovocal syndrome, refers to left recurrent laryngeal nerve palsy and hereby hoarseness due to cardiovascular disease. The palsy arises from compression of the nerve, as it passes between the aortic arch and the pulmonary artery. This case report describes a patient, who presented with hoarseness and recurrent laryngeal nerve palsy due to an 8 × 7.3 cm thoracic aortic aneurism, and it shows the importance of including cardiovascular diseases in the differential diagnosis of hoarseness in patients with cardiovascular risk factors.