A 51-year-old female with chronic pelvic complaints undiagnosed for many years. She was referred after her doctor saw a presentation I gave about pelvic venous disease in females. Workup of her pelvic pain using trans-vaginal and trans-abdominal ultrasound demonstrated an incompetent left internal iliac vein. CT venography was obtained, confirming severe compression of the left common iliac vein by the right common iliac artery. This is the most common variant of iliac vein compression syndrome and is known as May Thurner Syndrome. The patient underwent embolization of the pelvic varicosities, and stenting and venoplasty of the left common iliac vein with marked improvement in symptoms.