The persistent median artery (PMA) is an anatomic variation of the hand vascularity and is usually asymptomatic. The presence and thrombosis of PMA may result in several complications such as carpal tunnel syndrome. Early diagnosis and treatment of acute thrombosis of PMA is important because many complications and the need for surgery can be prevented with early anticoagulant therapy. In this report, we present the imaging findings of a thrombosed PMA causing acute wrist pain in a 36-year-old female case. Early anticoagulant therapy provided complete resolution of the symptoms. She had any evidence of carpal tunnel syndrome or another complication.