We report a rare case of the absence of the right superior vena cava and a persistent left superior vena cava in a 46-year-old man. This congenital venous anomaly was incidentally found on low-dose chest computed tomography and was clearly demonstrated by 3-dimensional volume-rendering image of multidetector computed tomography. Prior to computed tomography scanning, the scan range, optimal contrast enhancement, and reconstruction methods should be carefully planned to obtain the best diagnostic image of the venous anomalies using multidetector computed tomography.