Persistence of fetal intracranial arteries is rare. We review this anatomical literature regarding the persistence of the trigeminal artery and discuss the findings in two cadaveric cases both found to harbor this vessel. This anomaly should be considered by the clinician and anatomist who view imaging of the skull base. Additionally, the relationships between such an artery and other structures within the cavernous sinus should be understood by the neurosurgeon who operates in this region, e.g., transsphenoidal approaches to the skull base. © 2006 Wiley-Liss, Inc.