A mycotic pseudoaneurysm of the thoracic aorta is a rare entity in the pediatric population. It carries a high mortality rate associated with spontaneous rupture. Aortoesophageal fistula is a known complication of a pseudoaneurysm but is also rare in this group. A high index of suspicion is needed to make the diagnosis. This is aided by radiograph and computed tomography. We present such a case in an 11-year-old boy with previously undiagnosed coarctation of the aorta.