This case report describes a 33-year-old male who experienced acute symptomatic effort thrombosis, also known as Paget-von Schoetter syndrome, following an increase in his weightlifting regimen. The patient presented with right upper extremity swelling and venous engorgement, which was diagnosed as axillosubclavian vein thrombosis. Initial treatments, including thrombolysis and angioplasty, were ineffective, leading to surgical thoracic outlet release and the placement of a Wallstent. The patient has remained symptom-free for 10 months, both clinically and sonographically. The case highlights the effectiveness of a combined approach of thrombolysis, surgical release, and vascular stenting in treating refractory effort thrombosis.This case report describes a 33-year-old male who experienced acute symptomatic effort thrombosis, also known as Paget-von Schoetter syndrome, following an increase in his weightlifting regimen. The patient presented with right upper extremity swelling and venous engorgement, which was diagnosed as axillosubclavian vein thrombosis. Initial treatments, including thrombolysis and angioplasty, were ineffective, leading to surgical thoracic outlet release and the placement of a Wallstent. The patient has remained symptom-free for 10 months, both clinically and sonographically. The case highlights the effectiveness of a combined approach of thrombolysis, surgical release, and vascular stenting in treating refractory effort thrombosis.