Nutcracker Syndrome is a rare condition that involves mechanical compression of the left renal vein leading to chronic and debilitating left flank pain. The etiology of the pain is frequently misdiagnosed, and patients usually require long-term opioid use to manage their pain. Multiple therapeutic options for Nutcracker Syndrome have been described in the literature but the reports are limited by small numbers of patients, and the lack of convincing data demonstrating consistently improved outcomes. Here we report the largest series to date of patients undergoing renal auto-transplantation for the treatment of Nutcracker Syndrome.