To improve the operative procedure of the left renal vein nutcracker syndrome.Two patients underwent transposition of the left renal vein in the treatment of the left renal vein nutcracker syndrome.Renal ischemia, due to clamping of the renal artery, lasted 14 minutes and 13 minutes, respectively. The gross hematuria disappeared 1 day and 4 days respectively after surgery, and microhematuria ceased spontaneously 5 days and 7 days respectively after surgery. Transposition of the left renal vein effectively relieved the symptoms related to the left renal vein nutcracker syndrome. The patients had no recurrence of symptoms following up during 3 months.Transposition of the left renal vein is a safe and effective surgical approach in the treatment of the left renal vein nutcracker syndrome.