Abstract
A 15-year-old Indian boy from Guyana presented with episodes of syncope for past 4 years. Klippel-Trenaunay was entertained based on presence of capillary hemangioma and gross venous malformation of left leg. Unusual features noticed were “orthostatic hypotension as a presentation,” atrophy of leg as contrasted to common finding of hypertrophy, skeletal hypoplasia, abnormal venous and arterial features. Surgical management was undertaken in view of large venous pooling, and abnormal veins threatening to rupture, with good results.