Budd-Chiari syndrome (BCS) refers to thrombosis of hepatic veins as well as intrahepatic or suprahepatic inferior vena cava. We present for the first time a case of possible occurrence of Budd- Chiari syndrome with the history of depot medroxy progesterone acetate (DMPA) injections in a 33-yearold Iranian woman. An underlying disorder can be identified in most of patients with BCS. Many of these disorders are characterized by a hypercoagulable state, but it may occur due to other unknown pathophysiologic factors. Also, medical evaluation was performed for inflammatory, immunologic, and thrombotic disorders as well as hepatic imaging. Considering different case reports like this study may help to decrease the percentage of idiopathic cases