Effort thrombosis of the axillary and subclavian veins is an uncommon cause of upper extremity swelling. Prompt recognition and treatment of this disorder is important in order to minimize the complications of pulmonary embolism and post-phlebitic syndrome that can occur with this condition. This can be very challenging while underway or in the field. A sailor who developed effort vein thrombosis while underway on board the aircraft carrier USS Abraham Lincoln is presented to review the presentation and management of this disorder, particularly as it applies to active duty military personnel.