Varicose veins are a common condition in developed societies, often associated with valvular dysfunction but also secondary to other underlying pathologies. Secondary varicositis, characterized by superficial vein dilation due to venous obstruction or incompetence, presents significant challenges in patient management. May-Thurner syndrome, characterized by left common iliac vein compression by the overlying right common iliac artery against the vertebral body, is a noteworthy etiology contributing to secondary varicositis. Diagnosis involves clinical assessment and imaging studies, such as MR venography or duplex ultrasonography. Management strategies focus on symptom alleviation, disease progression prevention, and venous obstruction addressing. Conservative measures, including compression stock therapy, are initial treatments, with endovascular stenting or surgical correction reserved for refractory cases. This case report illustrates a comprehensive approach to managing secondary varicositis with May Thurner syndrome, emphasizing early recognition, accurate diagnosis, and tailored intervention for optimal patient outcomes.