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Vertebral artery (VA) is the largest branch of the first part o f the subclavian artery and the chief source ofblood supply to brainstem, cerebellum, occipital lobe o f cerebrum and posterior cranial fossa. Anomalousorigin, course and or branching pattern of VA may lead to disturbance in veitebro-basilar hemodynamics,risking cerebro-vascular insufficiency. A unique case of right VA having usual origin, but anomalous courseand branching pattern in its prevertebral segment is described. Moreover the right thyrocervical trunk wasabsent in present case and inferior thyroid artery branched off the variant VA. The ligation o f such vertebralartery may cause a compromise to thyroid in addition to posterior cranial fossa blood supply. The informationabout its course is crucial during diagnostic investigations and surgical procedures in the head and neckregion.