Abstract
This case report contributes to the limited literature by describing a man in his early forties who presented with symptoms suggestive of cauda equina syndrome (CES). Initial investigations focused on identifying a possible spinal lesion as the underlying cause. However, further imaging and multidisciplinary team assessment revealed a rare vascular anomaly: agenesis of the infrarenal segment of the inferior vena cava (IVC), a condition with a distinct etiology that requires a fundamentally different approach to management.