Median arcuate ligament compression of the renal artery.

Renal artery entrapment (RAE) is an uncommon form of median arcuate ligament or diaphragmatic crura compression. This case describes a woman in her mid-40s with an incidental finding of right renal artery stenosis by the right crus following renal donor protocol imaging. She was an otherwise healthy former smoker with no history of hypertension or atherosclerotic disease. Imaging demonstrated bilateral anatomical variants within her renal arterial system, including accessory renal arteries for both kidneys. She was deemed unsuitable to become a kidney donor, and her RAE was conservatively managed. This case highlights a unique presentation of asymptomatic RAE with concurrent renal arterial variants, underscoring the variable clinical presentation of RAE by the diaphragmatic crura and appropriate management.