Cough lasting more than three weeks has been defined as chronic cough. There is no consensus as to best diagnostic strategy for it. Empirical therapy, laboratory investigation or both are used to confirm the diagnosis. In addition, the cough may have different causes resulting from different regions. In some cases, it may be difficult to find out the cause. In this report, we present a rare case with persistent cough due to an underestimated ascending aortic aneurysm, which is also associated with sinusitis and gastroesophageal reflux.