Double RA-LRV is rarely reported anatomical variant that may present with left pelvis congestion. Embryologically in these cases, there is persistence of left sub-supracardinal anastomosis, the inter-supracardinal anastomosis, the left ventral renal vein and left supracardinal vein. A knowledge of this variant is essential during retroperitoneal surgeries, iatrogenic injuries and the fact that it may present with vascular compression and related hemodynamic problems.