Usually, flank pain signifies the presence of a renal/ureteric pathology. Here, we highlight an unusual cause of flank pain, which can be an important differential to be borne in mind while evaluating the causes of flank pain. Anatomical variants of the kidneys are very common, but rarely do they cause flank pain unless associated with an ongoing pathological process within them. We describe a case wherein an anatomical variant of the kidney, without any pathology, led to unremitting flank pain, purely due to its location and associated "vascular drag." Correction of the underlying anatomical defect afforded significant symptomatic relief.
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