Ovarian vein thrombosis is a rare condition that is usually due to prothrombotic states. The clinical presentation is nonspecific, commonly with abdominal pain. Anticoagulation is fundamental to prevent complications and reduce morbidity and mortality. Enoxaparin and warfarin have traditionally been the anticoagulants of choice. Direct-acting anticoagulants are an alternative under study. This publication presents a case of a 60-year-old patient without predisposing factors for ovarian thrombosis, with low back pain, where the diagnosis was only achieved with Computed Tomography. Anticoagulation with rivaroxaban was started for a period of 3 months, obtaining resolution of symptoms and thrombosis.