Anterior spinal artery syndrome caused by thoracic disc herniation.

•Anterior spinal artery syndrome caused by disc herniation is rarely reported as a result the upfront management remains controversial.•Anterior spinal artery (ASA) ischemia classically causes dysfunction of the anterior two-thirds of the spinal cord known as ASA syndrome.•We report angiogram proven ASA compression from a herniated disc managed with upfront surgery with excellent clinical outcome.