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Background: Preoperative knowledge of the presence of major venous anomalies facilitates the safe performance of aortic surgery. The purpose of the study was to estimate the incidence, as detected by abdominal computed tomography (CT), of major left renal vein anomalies related to the abdominal aorta in an adult population. Material and methods: Seven hundred and fifty abdominal CT examinations were reviewed retrospectively for the presence of left renal vein anomalies. Eleven CT scans were excluded from the study because of technical or patient-related factors. The course of the left renal vein was assessed on the CT slices to detect any anomalies. Results: Left renal vein anomaly was detected in 23 (3.1%) of 739 cases. Seventeen (2.3%) of them were a retro-aortic, and six (0.8%) of them were a circumaortic left renal vein. Conclusions: It is important to detect left renal vein anomalies before retroperitoneal surgery or interventional procedures. These anomalies can be identified in routine abdominal CT examinations with a careful inspection. (Folia Morphol 2012; 71, 3: 168–172)