Cases of vascular anomalies of the iliac and femoral vessels are rare. We report a complete absence of the right common iliac artery in a 21-year-old woman, incidentally discovered by CT during the work-up for acute abdominal pain. A network of prominent collateral arteries reconstituted the distal portion of the right external iliac artery and the common femoral artery, forming the arterial supply of the right lower limb. Multiple collaterals were also observed reconstituting the right internal iliac artery. At the time of presentation, the patient had no signs or symptoms to suggest lower extremity ischemia, however this may become a problem in the future. Recognition of vascular abnormalities can dictate extra caution when planning abdominal surgery.