This case study presents a rare iliac vascular injury in the absence of a pelvic fracture. A 36-year-old man sustained a blunt injury after being stuck by a motor vehicle. The only positive computed tomographic finding was in the pelvis that showed a 4 × 2-cm left retroperitoneal soft-tissue collection, appearing to encompass the left common and left external iliac veins. A pelvic venogram was obtained on Day 2 revealing a focal injury to the left external iliac vein with 60% narrowing. The patient was treated with clopidogrel and acetylsalicylic acid and discharged from the hospital to his home 3 days later. A follow-up pelvic venogram in 6 weeks later showed complete healing of previously visualized left external iliac venous injury without any residual stenosis.