BACKGROUND: Inferior vena cava (IVC) leiomyosarcomas are rare and aggressive tumors. Complete cure depends on achieving R0 resection, which often requires circumferential resection and reconstruction. Synthetic grafts have traditionally been used when venous continuity must be restored. However, the use of cadaveric IVC grafts for reconstruction has not been widely reported. CASE SUMMARY: Herein, we present the case of a 64-year-old woman diagnosed with an intrahepatic IVC leiomyosarcoma with local invasion. The patient responded favorably to chemotherapy and subsequently underwent an CONCLUSION: Cadaveric IVC grafts are an alternative to synthetic grafts for reconstruction, with acceptable outcomes. Larger, long-term studies are necessary to validate these findings.