The vertebral artery and its branches are target of arteriographic investigations, ultrasound and Doppler visualization, MRI and CT imaging in many contemporary diagnostic procedures. The big horizon of procedures in the interventional and diagnostic radiology, orthopedic and surgery opens new avenues for the study of anatomy and especially variations of the vertebral artery and its branches. The aim of the present report is to give a summary of the vertebral artery anatomy as well as its variations, and to emphasize there clinical importance.