Advance awareness of the renal vascular anatomy, including variants of the left renal vein, is important for abdominal and renal surgery. The migratory nature ofrenal embryology and significant transformation of precursors of the inferior vena cava and renal veins can make the final configuration of these structures complex. Two uncommon instances of dual left renal vein with orthotopic left common iliac vein and ectopic caval drainage are presented with multi-detector CT imaging.