The low insertion of the medial arcuate ligament is a rare topographical form which is the cause of an extrinsic compression of the coeliac trunk. In its asymptomatic form, its research is necessary if interventional radiology or above- meso-colonic surgery is required at the risk of compromising the evolution of vascular and/or pancreatico-bilio-digestive therapeutic gestures. The authors report a case of inserted and compressive low medial arcuate ligament of the coeliac trunk.