Arterial thoracic outlet syndrome (TOS) can be difficult to diagnose clinically. Recently, Magnetic Resonance Angiography (MRA) has been used to assist in the diagnosis of arterial TOS. The purpose of this article is to survey the current literature to establish the evidence for or against the use of MRA in the diagnosis of arterial TOS. The evidence-based search was conducted using PubMed, PEDro, Hooked on Evidence, EBM Journals, Ovid, Cochrane, and E medicine. The studies were graded as to the strength of recommendation and to the actual level of evidence. Statistics were calculated when sufficient data were present. The search yielded a total of seven studies. The studies received grades of recommendation that ranged from B to D. The current evidence in support of MRA as a valid test for diagnosing arterial TOS is weak and studies are not based on strong design.