Deep vein thrombosis as a common clinical syndrome finds its major risk factors in prolonged standing, immobility, old age, varicose veins, pregnancy, oral contraceptives, and cancer. However, an anatomical variant can also lead to blood clots in the lower extremity. May-Thurner syndrome, also known as iliac vein compression syndrome, is a rare condition in which the left common iliac vein is compressed by the right common iliac artery, thus increasing the risk of deep vein thrombosis in the left extremity. While this anatomic finding is present in over 20% of the population, most go undiagnosed as patients presenting with deep vein thrombosis have other accompanying risk factors. For severe May-Thurner syndrome, endovascular venous stenting may actually be necessary to prevent recurrence. In this case report, an 85-year-old woman with progressive swelling of left lower extremity was diagnosed with May-Thurner syndrome. When evaluating patients with unilateral leg pain and swelling, clinicians should keep in mind the possibility of May-Thurner syndrome as another possible risk factor of deep vein thrombosis.