Brachial plexus blockade requires efficient and thorough understanding of the detailed anatomy of the plexus and the variations associated with the plexus. Anomalies associated with the branches of the plexus may complicate attempts of nerve blockade for anesthesia. The present case report presents an unusual variation of brachial plexus noticed during routine cadaveric dissection. A rare neural communication between ulnar and radial nerves was observed in the left axilla at high humeral level proximal to the entry of the radial nerve into the radial groove. The communicating ramus also gave a branch to the medial head of triceps brachii 0.3 cm distal to the origin of the communication. Further, there was also a communication between the musculocutaneous and median nerves in the distal half of the arm after the musculocutaneous nerve pierced the coracobrachialis muscle.Though the variations of the brachial plexus have been described in the literature, yet studies regarding the communication between ulnar and radial nerves are rare and the coexistence of this variation along with median and musculocutaneous nerve communication is unique. Knowledge of such rare variations and anomalies is important to minimize the possible complications of regional anesthesia and surgery. Such an unusual variation, as noted in the present study, may prove useful in nerve grafting and neurophysiological evaluation to diagnose peripheral neuropathies. Further, their knowledge is of immense importance in traumatology of the shoulder joint, radial neck dissections and management of fracture of the surgical neck of humerus. Anatomic variations of peripheral nerves are important for Orthopedic surgeons, Neurophysicians, Physiotherapists and Radiologists. The present article is a humble attempt to reinforce awareness of such neural variations among clinicians
