Tumors arising from the inferior vena cava are rare. The commonest histological type among these rare tumors is leiomyosarcoma. Complete resection of the tumor is the mainstay of management. Concomitant right nephrectomy during resection may be required. As the collateral circulation of the left renal veins is extensive and well-developed, reconstruction of left renal vein is not required generally. This case report provides a situation, which may warrant the reconstruction of the left renal vein as the patient developed postoperative renal failure. Authors recommend the reconstruction of the left renal vein in a similar situation disregarding the collateral circulation.