Abstract
May-Thurner syndrome (MTS), also known as iliocaval venous compression syndrome, is a vascular condition characterized by extrinsic venous compression within the iliocaval territory. While traditionally considered a condition predominantly affecting women, this case report presents an atypical presentation in a middle-aged male patient. The patient initially presented with left lower extremity pain and swelling, which was attributed to deep venous thrombosis (DVT) in the left calf and femoral vein. Despite anticoagulation therapy, his symptoms persisted, leading to further diagnostic evaluation and the identification of MTS. This report highlights the clinical presentation, diagnostic challenges, and successful management of MTS in a male patient. Endovascular interventions, including balloon dilation and stent placement, were employed to address refractory stenosis and thrombus burden. The case emphasizes the importance of considering MTS as a potential diagnosis in patients with unexplained lower limb symptoms, irrespective of traditional risk factors or gender. Early identification and appropriate interventions can lead to symptom relief, obstruction resolution, and improved long-term outcomes for patients with MTS. This case underscores the need for heightened clinician awareness regarding MTS and its potential impact on patient care.