134ay-Thurner syndrome (MTS) or iliac vein compression syndrome occurs due to compression of left common iliac vein by right common iliac artery, anterior to lumbar vertebrae. 1 In this syndrome, there is increased risk for deep vein thrombosis (DVT), chronic venous stasis ulcers, and pulmonary embolism. 1 These patients have persistent left lower extremity swelling with or without deep vein thrombosis. The risk of DVT in the left lower extremity increases three to eight fold in MTS. 2 Upon clinical suspicion, the diagnosis of MTS can be confirmed by iliac venography, which is the gold standard for the diagnosis of MTS. 3 There are many different treatment options like conservative management, endovascular technics, and surgery.