Low QRS voltage on surface electrocardiogram (ECG) is traditionally defined as a QRS amplitude less than 0.5 mV in all frontal leads or less than 1 mV in precordial leads [1]. Causes of low QRS voltage include diminished heart generated potentials (cardiac causes) and impairment of signal transmission from the myocardium to the skin electrodes (extracardiac causes) [2]. Previously, it has been suggested that an enlarged aorta may interfere in signal transmission from the heart and attenuate QRS amplitude on ECG [3]. In this case report, we describe an unusual finding of low QRS amplitude confined to the first three precordial leads (V1-V3) in a patient with ascending aortic aneurysm.