Congenital anomalies of ribs are rare incidental findings. Structural malformations of first rib are common as compared to other ribs. When such anomaly is present, may lead to compression of neurovascular bundle at the root of the neck causing thoracic outlet syndrome (TOS). The reported case of a rare bone specimen was an incidental finding during routine sorting of bones from the department. The specimen displayed fusion of right sided first and second rib in the midshaft region with free anterior and posterior ends. Such skeletal abnormality may be associated with segmentation defects of bony tissues and variations in the disposition of neurovascular structures, thus making them vulnerable for compression at thoracic outlet. Thus the awareness and precise knowledge of such anomaly is important for the anatomists, radiologists and thoracic surgeons dealing with this region.