The retro-psoas iliac artery is a rare vascular anomaly that has been reported few times in the literature; and while it may be clinically silent with no specific symptoms; reporting it can prevent many complications that may arise during surgical and interventional procedures. We report a case of a 40-year-old male who presented with progressive neurological symptoms, and was found to have a right retro-psoas iliac artery as an incidental finding on a lumbar spine MRI....