Congenital retinal macrovessel is a rare condition in which anomalous retinal vessels cross the macula. Visual impairment can result if the anomalous vessels pass across the foveola, if foveolar cysts form, or if hemorrhage occurs. A now 17-year-old African-American female has an anomalous retinal vein that crossed the macular region beyond the horizontal raphe in her left eye. This patient exhibited the classic characteristics of congenital macrovessels. Her visual acuity remained unaffected after a 5-year follow-up and therefore treatment was not required.