All included: -->Medela Symphony hospital grade breast PUMP --> LIKE NEW, Perfect Condition --> 0 errors! (very important!) --> just 912hr (really few! because the first service should be at 6,000 hr) -->Medela Portable PUMP in style (great pump for work or going out) connection to the car or batteries. -->Medela Manual PUMP (to leave in the car, for example, just in case) -->Medela breast pump CARRY BAG thermal And ALL the ACCESSORIES and supplies you could potentially need, just a few are open. All in the pictures are included.