Variations in venous circulation can affect either the superior or inferior vena cava, with diagnoses often being incidental and presenting with highly variable symptoms. This case discusses the detection and investigation of bilateral superior vena cava agenesis in an asymptomatic patient. Systemic venous anomalies affecting the superior vena cava (SVC) are rare developmental disorders that occur during embryological development. SVC anomalies are usually asymptomatic but can complicate procedures such as cardiac catheterization, systemic venous cannulation for extracorporeal membrane oxygenation, and transvenous pacemaker implantation[1](#ref-0001). These anomalies are typically diagnosed through echocardiography, computed tomography (CT), magnetic resonance imaging (MRI), or during failed cardiac or venous catheterization due to IVC course anomalies[2](#ref-0002). They are more common in males and may be associated with congenital heart diseases, rhythm disturbances, or both[3](#ref-0003). The most common SVC anomalies include the presence of bilateral SVC and the absence of the right SVC with persistent left SVC[4](#ref-0004). Bilateral SVC absence is extremely rare.
