A 29-year-old man with no significant medical history presented with lower abdominal discomfort of 2-week duration. He was obese (body mass index, 44 kg/m2) and hypertensive (BP, 160/90 mm Hg), and had moderate bilateral pedal edema. Abdominal examination revealed a right-sided varicocele. Cardiovascular and respiratory examination findings were normal. Doppler ultrasound revealed a right renal vein thrombosis and confirmed the presence of a varicocele on the same side. Laboratory investigations revealed mild renal impairment and moderate proteinuria. A tight stenosis of the infrahepatic portion of the inferior vena cava was identified on a magnetic resonance venogram in addition to the Doppler ultrasound findings. The presence of collaterals suggested that the occlusion was not a recent occurrence.