Objective: To emphasize the incidence and clinical, diagnostic and surgical implications of left renal vein developmental anomalies. Design: Retrospective analysis of case notes. Setting: Clinical Anatomy Department and Surgery Department, Faculty of Medicine, University of Valencia, Spain. Patients, participants: Standard radiological examinations (CT scan) performed on 745 patients; surgical findings at operation in 128 patients with aorto-iliac atherosclerotic disease, and 72 donor cadavers for transplantation. Main outcome measures: Incidence of left renal vein anomalies (retro-aortic left renal vein and peri-aortic renal venous collar), based on radiological (CT scan) and surgical observations. Analysis of implications to surgical management. Results: The radiological series disclosed a 2.68% incidence of left renal vein anomalies: 1.33% retroaortic left renal vein, and 1.33% peri-aortic renal venous collar. The surgical series showed a 1.5% incidence of both anomalies. Conclusions: The importance is stressed of these relatively uncommon but hazardous conditions, which should be familiar to anatomists, radiologists and surgeons.

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