Anomalous origin of the pulmonary artery (AOPA) is a rare congenital condition with significant clinical implications. We present a unique case of a 5-day-old neonate exhibiting respiratory distress, diagnosed with AOPA from the left innominate trifurcation confirmed by computed tomography pulmonary angiography (CTPA). This specific variant has not been previously reported. The patient had a large sub-aortic ventricular septal defect (VSD) and an overriding aorta. Early diagnosis and surgical intervention are critical for improving outcomes, underscoring the need for heightened clinical awareness and prompt management of this condition.  Kulcsszavak: anomalous origin of left pulmonary artery, left hemitruncus anomaly, innominate trifurcation, ventricular septal defect anomalous origin of left pulmonary artery, left hemitruncus anomaly, innominate trifurcation, ventricular septal defect