During a routine dissection we observed an anatomical variation of the median nerve and an atypical anastomosis in the palm region of a male cadaver. There were four distinct recurrent motor branches of the left median nerve and the palmar cutaneous branch of the ulnar nerve communicated directly with the third common palmar digital nerve. The presence of such anatomical variant in the hand should keep surgeons alert in the management of hand pathology especially in carpal tunnel syndrome which is a routine operation for many medical centers
