In this report, we describe a case of deep vein thrombosis with suspected congenital inferior vena cava atresia treated with thrombolysis, angioplasty, and bilateral "kissing" iliac stent placement. An 18-year-old male presented with left common iliac vein thrombus and suspected congenital inferior vena cava atresia. He was treated over 4 days and discharged on anticoagulation which was continued long-term. These treatments were shown to be clinically successful in treating and preventing re-thrombosis in the context of inferior vena cava atresia initially presenting with symptomatic bilateral lower extremity deep vein thrombosis.