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We present a pictorial review of anomalous origin of the left vertebral artery observed in 5 patients imaged in our after-hours trauma radiology unit within a period of 7 days. We raise the question of whether the incidence of anomalous origin of the left vertebral artery quoted in the radiology literature as 5% is really that low, and suggest that the current increased frequency of cross-sectional imaging could elevate the observed incidence of this anomaly in practice. We discuss thedoi:10.4102/sajr.v16i4.262 fatcat:vrpwdn4ttjb5rfw3uuxntiqi4a