This is the first report of the use of computed tomography (CT) in a patient with classic features of superior mesenteric artery (SMA) syndrome. CT was able to simultaneously demonstrate the characteristic duodenal distension and the close proximity of superior mesenteric vessels and aorta. In addition, it was possible to show that CT signs improved after clinical symptoms disappeared during adequate nutritional therapy. CT together with anthropometric data indicated that the deposition of fat did not play the expected role in the resolution of SMA syndrome.