Inferior vena cava filters are a useful therapeutic option for patients in whom anticoagulant therapy is contraindicated or ineffective, especially those at high risk of bleeding. These filters can erode or penetrate the wall of the inferior vena cava, injuring adjacent retroperitoneal and abdominal organs, especially the duodenum. The perforation rate is estimated to be as high as 4%–40%, although there are no clinical symptoms. We describe two cases: one with a duodenal perforation and another with an inferior vena cava filter transfixed to the lumbar spine (L2 to 3). A brief review of the literature is also provided as is a discussion of the presenting symptoms and treatment regimen for such rare complications.