Prepancreatic portal vein is an extremely rare congenital anomaly. It is even rarer in the setting of intestinal nonrotation. We report a case of prepancreatic portal vein in a 71-year-old female with nonrotation who presented with a pancreatic adenocarcinoma in the tail of the pancreas who underwent a distal pancreatectomy and splenectomy. This anomaly was identified prior to surgery on CT scan of the abdomen.