Background: Nutcracker syndrome (NCS) is a rare vascu-lar compression disorder characterized by left renal vein (LRV) entrapment, leading to various clinical manifestations. Aim of Study: The current study aimed to evaluate the sur-gical outcomes of patients with NCS. Material and Methods: A retrospective analysis was con-ducted on 10 patients with NCS who underwent surgical inter-vention at Tanta University Hospitals, Egypt between January 2021 and February 2024. Intraoperative techniques employed varied based on individual findings, including LRV transposi-tion, patch venoplasty, and renocaval bypass grafting. Results: The mean age of the patients was 20.3±3.09 years, with a predominance of males (80%). The mean body mass in-dex was 20.5±2.96kg/m2, and the mean aortomesenteric angle was 24.3±4.14°. Postoperatively, a significant reduction in pain (p<0.001) and hematuria (p=0.010) was observed compared to preoperative levels. Varicocele showed an insignificant differ-ence (60% vs 20%, p=0.169). Improvement was noted in 80% of patients, while 20% experienced postoperative infections. Conclusions: Surgical intervention for NCS demonstrated promising outcomes, with significant alleviation of pain and hematuria in the studied cohort. While varicocele improvement was statistically insignificant, the majority of patients experi-enced overall symptomatic relief.