A case of complete inferior vena cava obstruction with resultant unusual collateral circulation is reported. On venographic examination of a 50 yar old male who showed complex superficial collateral channels on right side trunk, complete obstruction of the middle portion of inferior vena cava was demonstrated, and thereafter main collateral flow was just served with inferior phrenic, lumbar, and vertebral venous plexus veins. Systemic venous blood from the above collateral channels was mainly connected not with the usual azygos-hemiazygos system to the superior vena cava but with the left cardiophrenic or superior phrenic vein which was proven to present itself as scalloped nodular densities along the left cardiac border on the plain chest film. Brief comments on the collateral circulation is described with review of literatures.