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Introduction: The current imaging report describes a unique coexistence of the neck venous system morphological variants. Methods: The imaging study of a 75-year-old male patient was isolated due to its unique venous system. Results: An internal jugular vein (IJV) duplication (main-typical and accessory IJVs) was identified on the right side, coexisting with a facial vein (FV) drainage into the accessory IJV. On the left side, the external jugular vein (EJV) was draining into the IJV and the FV into the EJV. A transverse anastomosis of the EJV and anterior jugular vein (AJV) was identified. Conclusions: The IJV duplication is a rare morphological variant, and its coexistence with other co-variants complicates the area's anatomy. Understanding these morphological variants is crucial for anesthesiologists and surgeons, as it can help prevent iatrogenic injury.