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In the operating theater, it is of the upmost importance that the surgeon has a comprehensive knowledge of the anatomy within their surgical field. For the otolaryngologist, intimate knowledge of the neurovascular anatomy of the neck is required, especially during surgical procedures relating to the thyroid gland. Along with knowledge of the typical anatomy, the otolaryngologist should also be aware of specific anatomical variants. One such variant is the thyroid ima artery, commonly located inferior to the thyroid gland. In the study presented, 26 cadavers at Edward Via College of Osteopathic Medicine were carefully dissected, and it was determined that two of 26 (further identified as donor 121 and 303) displayed the variant ima artery. For donor 303, the artery was located supplying a pyramidal lobe on the inferior portion of the thyroid gland, and originated from the brachiocephalic artery. It is the authors hope that this case study lends to further knowledge of the thyroid ima and its characteristics, and ultimately improved surgical awareness.