Joey, a 1.5 year old intact male mixed breed dog presented to the emergency service at Cornell University Hospital for Animals on 8/10/07 with a pronounced upper respiratory stridor and a history of regurgitation. Bilateral laryngeal paralysis was diagnosed via upper airway exam. To determine the cause of regurgitation, numerous diagnostics were performed including a complete blood count, chemistry panel, acetylcholine receptor antibody test, thoracic radiographs, a fluoroscopic esophagram, angiography, and computed tomography. Ultimately, a persistent right aortic arch with a left ligamentum arteriosum and a left aberrant subclavian artery was diagnosed. The esophageal constriction formed by the left ligamentum arteriosum was corrected surgically and regurgitation eventually resolved. This report describes Joey's case in detail and discusses the pathogenesis, clinical signs, diagnosis, treatment, and prognosis of this disease.