The high prevalence of varicocele and poor knowledge of etiology of this condition imply the necessity of its in-depth investigation. There is a variety of opinions about the influence of different anatomical variants of vein formation on the development of varicocele. There are practically no publications describing the occurrence of varicocele in the patients with congenital malformations of the inferior vena cava (IVC), left renal vein (LRV), and left internal spermatic vein (LISV). Material and methods. Phlebography by the standard methods was performed on 111 patients presenting with left-side varicocele admitted to the Central Military Clinical Hospital of the Russian Ministry of Internal Affairs. Results. Seven (6.3 %) patients had congenital malformations of venous vessels. Three of them exhibited double IVC, two had abnormally developed LRV and two others showed abnormalities in LISV. In the patients with double IVC, its both trunks were actually the extensions of the common iliac vein. One of the patients suffered occlusions of the retroaortic intercaval LRV anastomosis. The patients with double IVC experienced reflux of the contrast agent in spermatic veins. Digital dynamic angiography in the patients with double IVC revealed that each vein had a smaller diameter than the normal single-trunk vessel which resulted in the disturbances of the laminar blood flow at the level of renal veins and slowed down blood outflow from spermatic veins. The retrograde localization of the intercaval anastomosis was also responsible for the slowed down blood outflow in spermatic veins. Conclusion. The present study has demonstrated that congenital malformations of the veins draining pampiniform plexus play an important role in pathogenesis of varicocele. The results of digital dynamic angiography may be used to choose the method of surgical intervention adequate to the concrete anatomic and hemodynamic conditions.