Since the left gonadal vein drains via the left renal vein it can also result in left testicular pain[5] in men or left lower quadrant pain in women. Nausea and vomiting can result due to compression of the splanchnic veins.[5] An unusual manifestation of NCS includes varicocele formation and varicose veins in the lower limbs.[6] Another clinical study has shown that nutcracker syndrome is a frequent finding in varicocele-affected patients and possibly, nutcracker syndrome should be routinely excluded as a possible cause of varicocele and pelvic congestion.[7]