Abstract
The development of the pulmonary tissue begins as early as the 4th week of embryonic life. While the majority of the adult structures are achieved by birth, the development of alveoli continues up to the age of 8. Given this prolonged course, it is natural to expect errors. The errors however are far and few. Of the rarest errors in lung development is that of lung agenesis. This case, in particular, is that of lung agenesis in conjunction with multiple vascular anomalies making it unique. While the absence of the lung tissue should ideally be easy to diagnose, many are asymptomatic. It is unsurprising to find associated anomalies in conjunction with agenesis of lung tissue. What further complicates this pathology is its similarity to diseases for instance, such as asthma, lung collapse and Post Tb sequelae. This combination of lung agenesis and the myriad of other pathologies presenting similarly is what makes its identification challenging. These interesting features prompt us to report this case. While regular health visits are vital for every individual, an appropriate physical examination and investigations will expedite the diagnosis and allow for a fitting treatment for these cases. 

Key words: Opaque hemithorax, Cyanosis, lung agenesis