Retroaortic left renal vein is a relatively uncommon venous anomaly. Its cl
inical importance is unclear, but diagnostic and surgically hazardous impli
cations make it a condition that must be kept in mind. Computed tomography
(CT) scanning has been largely advocated as the most accurate imaging metho
d in assessing this anomaly. Digital subtraction angiography (DSA) is not u
sually reported as detecting retroaortic left renal veins. The authors repo
rt a case in which a retroaortic left renal vein could be detected both by
CT scan and by DSA, a finding that could be confirmed intraoperatively duri
ng aortic aneurysm surgery. Most of the relevant literature is briefly comm
ented on and reviewed.