Caput medusae is a term derived from latin meaning the head of medusa from Greek mythology as a clinincal description of superficial epigastric vein engorgement. Portal hypertension due to cirrhosis or Inferior Vena Cava (IVC) obstruction can result in re-canalization of periumbical veins resulting in prominent engorgement. Although not highly specific but if occlusion of a prominent vein results in flow towards the leg then it is considered to be caput medusae alternatively if the flow is towards the head then it is suggestive of IVC obstruction.