Internal jugular vein (IJV) thrombosis is exceedingly rare and it is typically the result of head and neck infections or trauma, intravenous drug abuse or long-standing central venous catheters. Malignancies are also a cause of IJV thrombosis. We present a case of bilateral IJV thrombosis in a 48-year-old man. Additional investigations revealed a malignancy of the stomach. Based on a search of the literature, we suggest that patients with spontaneous and/or recurrent IJV thrombosis should undergo thorough investigation to prevent overlooking an occult malignancy.