The fetal posterior communicating artery is a well-established variant of the cerebral vasculature, occurring in 4-29% of the population. This variant can provide unique challenges in the identification and treatment of cerebrovascular disease or a cerebrovascular accident. Here we present a cadaveric case showing the presence of the fetal-type posterior communicating artery with a contralateral calcified internal carotid artery and discuss the importance of understanding this embryological variant. This case provides specific and unique clinical sequelae that require treatment to be initiated while understanding the various complications that may arise.