The paired first thoracic sympathetic ganglia are the most superior of the twelve thoracic ganglia in the sympathetic chains on either side of the spinal column. They are continuous with the inferior cervical ganglia that lie superiorly; often both fuse to form the stellate ganglion.
The first thoracic ganglion is sited inferiorly to the neck of the first rib with the following structures progressively more lateral: supreme intercostal vein, superior intercostal artery, ventral ramus of first thoracic nerve.
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