Posterior mediastinal tumors surgery may be complicated by their proximity to the artery of Adamkiewicz (AKA) and its segmental supplier, increasing the risk of ischemia of the spinal cord. We describe a case of preoperative identification of the AKA with magnetic resonance angiography (MRA) in a 14-month-old boy diagnosed with a thoracic neuroblastoma, thus allowing an accurate surgical planning in order to avoid injury to those vessels. Given the relatively high incidence of posterior mediastinal tumors in the pediatric age, MRA may establish itself as a viable alternative for this purpose, even in young children.