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Transvenous pacing is a relatively safe treatment with a low complication rate. However serious thromboembolic complications can occur. Superior vena cava obstruction syndrome is generally rare after pacemaker implantation. Usually most patients remain asymptomatic because of the development of an adequate venous collateral circulation. Venous obstruction often first becomes apparent during pacemaker lead revision. In this report, we present a case of pacemaker associated superior vena caval obstruction syndrome.