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Central venous access is one of the most commonly performed medical procedures, requested often to initiate chemotherapy or hemodialysis. Duplicate superior vena cava (SVC) or left sided SVC are rare venous anomalies, more often seen in patients with congenital cardiac issues. Most patients are asymptomatic and the anomaly is an incidental finding at time of catheter placement. This case report presents a duplicate superior vena cava discovered when attempting Mediport placement under fluoroscopy for chemotherapy. Clinical awareness and recognition of this rare venous anomaly is important because it can lead to life threatening events.