Barw Barw Medical Journal 2960-1959 2024 09 25 A Unique Positioning of Saphenofemoral Junction: A Case Report and Literature Review 10.58742/bmj.v2i3.111 eng Fahmi H. Kakamad College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaymaniyah, Iraq. fahmi.hussein@univsul.edu.iq Rezheen J. Rashid Department of Radiology, Hiwa Hospital, Sulaymaniyah, Iraq. rezheen.rashid@gmail.com Shvan H. Mohammed Xzmat Polyclinic, Rizgari, Kalar, Iraq. shvanh80@gmail.com Nasren Sharef Sabr Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq. nasren.sabr@gmail.com Ali H. Hasan Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq. ali.hasan@gmail.com Ayoob A. Mohammed College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaymaniyah, Iraq. ayoob12@gmail.com Farman J. Ahmed College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaymaniyah, Iraq. farman.faraj@gmail.com Dana H. Mohammed-Saeed College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaymaniyah, Iraq. dana.saeed@gamil.com Hawkar A. Nasralla Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq. hawkar.arf96@gmail.com Sharaza Qadir Omer College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaymaniyah, Iraq. sharaza.omer@gmail.com 2024 10 10 Introduction The saphenofemoral junction (SFJ) serves as a proximal link joining the superficial and deep veins in the lower limbs. Its anatomical position is typically 2.5 cm inferior and 4 cm lateral to the pubic tubercle. This study reports an exceptional case wherein the SFJ was found in the lower thigh. Case presentation A 24-year-old male presented with left leg pain and swelling for five years duration. Clinically, the left lower limb showed noticeable varicose veins. The duplex ultrasound showed several enlarged varicose veins, primarily around the knee. However, the SFJ was observed roughly 15 cm below the pubic tubercle, with a reflux lasting more than four seconds. The patient declined all therapy modalities, and regrettably, he was lost to further follow-up. Literature review No prior reports were found in the literature describing such an abnormal positioning of the SFJ approximately 15 cm below the pubic tubercle. Conclusion In conclusion, while the lower limb veins have various anatomical variations, locating the SFJ in the mid-third of the thigh is rare and has not been documented in the literature.