Double inferior vena cava is a rare congenital anomaly. Recognition of such venous anomalies is important in the evaluation and surgical treatment of retroperitoneal disease. Newer radiological modalities such as three-dimensional reconstruction of spiral computed tomography help to define such anomalies and avoid significant morbidity during surgical exploration. We present a case of renal cell carcinoma involving left kidney with tumor thrombus extending into both venae cavae, treated by left radical nephrectomy with vena caval thrombectomy.