We describe a case with pararenal abdominal aortic aneurysm associated with anomalous inferior vena cava. We applied the technique similar to that employed in the thoracoabdominal aneurysm repair consisting of mild hypothermic cardiopulmonary bypass and selective visceral perfusion. Replacement of the abdominal aorta and reconstruction of the left renal artery were completed without an injury to the anomalous vein.