The most frequent anatomical variations of the renal arterial system are accessory renal arteries (supernumerary renal arteries) and aberrant renal arteries, which occur in varying numbers among various ethnic and racial groups. Prior to surgery, understanding these variations is crucial because it affects the decision to use donor kidneys, the planning of partial nephrectomy, and other urological procedures. Along with the main renal artery on the same side, there is also an accessory renal artery. The aberrant artery supplies the kidney without passing through the hilum, whereas the main renal artery enters the kidney through the hilum to do so. Aim: This tertiary care hospital-based study aims to know the prevalence of variations of the renal arterial system including accessory renal artery, their distribution pattern, and association with gender, age, and side predilection in population of Kancheepuram and West Chennai district of Tamil Nadu. Methodology: One hundred adults (62 males, 38 females; mean age: 45 +/-25 years) inclusive of prospective live renal donors undergoing pre-operative CT renal angiogram for operative planning and other patients undergoing CECT Abdomen for various abdomino-pelvic pathologies were selected for the study. Research Design: it is a cross-sectional descriptive study conducted in the Department of Radiology, of a tertiary care hospital in Kancheepuram district of Tamil Nadu, India. Results: Renal artery variants (including Accessory renal and aberrant renal arteries) are present in 23% of kidneys. The prevalence of renal artery variants in malesis 30%, and in females -11%. On the right side the prevalence is 60% and on the left side is 26%. The prevalence of bilateral renal artery variants is 11%.