We present a rare case of an ectopic main right renal artery originating as part of the coeliac axis. Renal arteries are usually paired vessels which originate directly from the aorta to supply each kidney. Variations in their origin and numbers have been reported by many authors. However, there has only been one previous report of a left main renal artery arising from the coeliac axis in the medical literature, in 1980, seen during angiography. We believe we have the first CT angiographic evidence of such anatomy. This important aberrant anatomy must be noted not only for its rarity but also for its implications in the field of transplant surgery and interventional radiology. There will be more similar reports as non-invasive imaging is being used ever more frequently.
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