Horseshoe kidney (HSK) is a common renal anomaly associated with an increased risk of traumatic injury due to its superficial location and frequent vascular anomalies. We report a case of a 23-year-old male patient with HSK and a rare vascular anomaly, a right renal artery originating from the left common iliac artery, who sustained a grade V renal injury following blunt trauma. Contrast-enhanced computed tomography (CT) revealed active arterial bleeding and a retroperitoneal hematoma. Emergency transcatheter arterial embolization (TAE) successfully controlled active bleeding. The patient recovered without complications. This case underscores the importance of pre-procedural vascular evaluation in HSKs, as well as the efficacy of TAE in managing severe renal injuries associated with complex vascular anatomy.