Superior mesenteric artery syndrome (SMAS) is a rare clinical disease. SMAS is defined as the entrapment of the third portion of the duodenum by the aorta and the superior mesenteric artery. A 14-year-old male patient was admitted to the local hospital for an emergency appendectomy under general anesthesia. In the process of inducing general anesthesia, massive pulmonary aspiration of gastric contents and bile juice occurred by accident. After surgery, he was transferred to our hospital due to severe ARDS. The gastroduodenoscopy observations, CT, and clinical symptoms, were indicative of SMAS. Surgery was considered because medical conservative treatment of SMAS was ineffective. SMAS was confirmed on the surgical fields. We report our experience with a review of the relevant literature because this condition can be associated with serious complications during general anesthesia.