Congenital absence of the left external iliac vein with anomalous venous connection in a pediatric patient

We report an interesting case of a 2-year-old boy with congenital absence of the left external iliac vein and an anomalous lower extremity venous connection. Magnetic resonance imaging was used to identify aplasia of the vessel and aid in the diagnostic algorithm. In the present report, we have discussed the relevant literature associated with congenital venous anomalies and their clinical presentations and treatment options. Our patient did not undergo surgical intervention for his vascular malformation. (J Vasc Surg Cases Innov Tech 2023;9:101134.)