ABSTRACT Background: Renal vascular anatomical variations are common and clinically significant, particularly in renal transplantation, urological surgery, and interventional radiology. Meticulous preoperative evaluation of these variations using computed tomography (CT) or any other imaging is essential to reduce surgical complications. However, data on renal vascular anatomy in Ethiopia based on modern imaging techniques remains limited. Objective: To determine the prevalence and patterns of renal vascular anatomical variants among patients undergoing abdominal CT imaging at Tibebe Ghion Comprehensive Specialized Hospital, Bahir Dar, Northwest Ethiopia. Methods: A hospital-based retrospective cross-sectional study was conducted among 285 patients who underwent contrast enhancing abdominal CT imaging. Renal arterial and venous anatomies were evaluated for the presence, laterality, number, and type of vascular variants as well as its relation with demographic data and also some renal anomalies. Data were analyzed using descriptive statistics Results: Of the 285 patients, 148 (51.7%) were male and 137 (48.3%) were female, with a predominance of middle-aged and elderly adults. Renal artery anatomical variants were identified in 93 patients (32.6%). Accessory renal arteries were present in 48 patients (16.8%), more commonly on the left side (10.8%) than the right (3.5%), with 2.4% showing bilateral involvement. Early branching of the renal artery was observed in 13.3% of patients. Aberrant renal arteries were relatively uncommon (3.5%). Renal vein variants were detected in 42 patients (14.8%). The most frequent venous variation was a retroaortic left renal vein (9.4%), followed by circumaortic renal veins (1.7%) and supernumerary renal veins (1.7%). Associated renal anomalies were rare (2.1%). There was statically significant association between renal anomaly and vascular variants Conclusion: Renal vascular anatomical variants are relatively common in this population, particularly arterial variations. Routine preoperative CT evaluation of renal vasculature is crucial for safe surgical and interventional planning.