Coarctation of the abdominal aorta, also known as middle aortic syndrome(MAS), is very uncommon vascular pathology caused by a long segment narrowing of the abdominal aorta presenting variably with physical signs of coarctation of the aorta, hypertension, renal insufficiencyand/or mesenteric ischemia. Etiology of MAS may be acquired or congenital. Here we report the case of a 64-year-old man with severe hypertension. The diagnosis of hypoplasia of abdominal aorta associated with both renal artery stenosis was made using with computed tomography(CT) and magnetic resonance(MR) angiography. To our knowledge, this atypical type of aortic coarctation has not been previously described in Korea.