The medial circumflex femoral artery contributes to the blood supply of the adductor muscles, hip joint, and femoral head. Its variations are common and important in the surgical field, as its damage can cause femoral head necrosis. Most commonly, the variations include different origin patterns from the femoral artery or its branches.Here we report a very rare variation of suprainguinal origin of the medial circumflex femoral artery from the external iliac artery in the common trunk with the inferior epigastric artery. Because of the rarity, such an arterial variation not commonly suspected during open or laparoscopic surgery may result in devastating consequences.