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The superior mesenteric vein (SMV) is a major venous tributary of the abdominal cavity. Embryologically derived in association with the vitelline vein, the superior mesenteric vein lies lateral to the superior mesenteric artery (SMA) and serves to drain the vast majority of the organs of the abdominal cavity. At the most superior aspect, the superior mesenteric vein joins with the splenic vein, ultimately forming the portal vein. At the mesenteric root, it is of utmost importance that the vascular anatomy is correctly identified to perform complex abdominal surgical procedures. There are several clinical complications involving the superior mesenteric vein that clinicians must readily identify due to their life-threatening nature. This article will serve as a comprehensive review of the anatomy, embryology, function, and clinical significance of the superior mesenteric vein.