Superior vena cava (SVC) syndrome can be fatal if not discovered early. Most SVC syndrome presentations are related to malignancies; lung cancer in particular. The presentations may vary, depending on severity of SVC obstruction. We report a case of mild SVC syndrome of a 70-year-old gentleman who presented with a one-month history of intermittent plethora and facial puffiness. Computed tomography scan of the chest revealed superior mediastinal mass which may represent matted lymph nodes obstructing SVC with bilateral pleural and pericardial effusion. Biopsy of the mass was done, and non-small cell lung carcinoma was diagnosed. Clinical presentation, differential diagnoses and issues relating to SVC syndrome were discussed with the emphasis on early recognition of mild symptoms and prompt management.