Iliac compression syndrome: a myth, a rarity or a condition frequently missed?

A case of the iliac compression syndrome is reported and the literature on the subject reviewed. The anatomical abnormality which may cause symptoms in this condition is a frequent radiological and necropsy finding whose significance has been the subject of considerable debate. Evidence is presented that left iliac vein compression by the overlying right common iliac artery may cause symptoms of venous hypertension in the absence of venous thrombosis. As the condition may carry a risk of iliofemoral thrombosis with subsequent major morbidity and is surgically correctable it should be considered in the differential diagnosis of all patients presenting with oedema of the left leg.