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We report a case of an adolescent female with history of neurofibromatosis type 1 (NF1) found to have incidental hypertension. She was hypertensive in all four extremities with medical treatment. CT angiogram confirmed narrowing of the abdominal aorta above the bifurcation and atrophic left kidney (figures 1⇓–3). Treatment with a graft to bypass the stenotic segment was performed (figure 4).