Middle-aortic syndrome is a surgically curable cause ofchildhood hypertension. Open surgery is traditionallyoffered but with the advance of medical technology,endovascular approached is available in many country.Failure to control BP in open surgery is as low as 4.1%compares to 13% in endovascular approaches. However,mortality is 4% in open surgery almost 2 times higher than2.3% in endovascular approach. This article presents a caseof 10 years old child treated successfully withoutcomplication with endovascular balloon dilatation, as a firstcase of such disease in East Malaysia.