Ectopic kidneys are rare and usually present incidental findings during invasive or non-invasive angiography. Their parenchyma is not more susceptible to disease and symptoms occur mainly due to alteration of the anatomic relations. The main renal artery of the ectopic kidney derives invariably from the aorta; however, accessory renal arteries may originate from almost any arterial branch adjacent to the ectopic kidney. Knowledge of the common anatomic variations is important during complex peripheral interventions. We present the case of a 46-year-old male with symptoms of claudication secondary to left common iliac artery occlusion. He was diagnosed as occlusion of the left common iliac artery at the aortoiliac bifurcation in close proximity to the ectopic renal artery by peripheral angiography, and percutaneous intervention of the left common iliac artery was successful. Percutaneous intervention led to resolution of the patient's symptoms of claudication as well as preservation of the ectopic renal artery. In such cases, renal ectopy and aberrant arteries should be promptly recognized in order to avoid vascular or renal complications.