Nutcracker syndrome is a vascular anomaly, of which the posterior variant characterized by the compression of the left renal vein between the aorta and the spine, is extremely rare. We present a case of a 40-year-old female patient with acute lumbar pain subsequently diagnosed with posterior variant of nutcracker syndrome complicated by left renal vein thrombosis and suspected renal infarction. Treatment involved an endovascular intervention – mechanical thrombectomy and balloon angioplasty – as well as anticoagulant therapy, successfully restoring flow in the left renal vein. The paper discusses current diagnostic and therapeutic trends in this rare anatomical variant.