Common iliac artery (CIA) thrombosis is a rare surgical complication which may cause serious leg damage and may occasionally be fatal. We experienced two cases of CIA thrombosis in nephroureterectomy with the pluck technique for upper tract urothelial carcinoma. Patients were treated using emergent femoro–femoral bypass, and one patient was treated with fasciotomy of the lower extremity for compartment syndrome. CIA thrombosis is considered a possible complication of nephroureterectomy, particularly with the pluck technique in open surgery. Arterial thrombosis in intrapelvic surgery including nephroureterectomy should be carefully considered for patients at risk.
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