Introduction: The cephalic vein is formed by dorsal venous arch on the radial side of the upper extremity. Its course was normal till deltopectoral groove. It then communicates with the subclavian vein by crossing superficial to clavicle instead of emptying into the axillary vein.
Case Report: The rare variant of supraclavicular course of subclavian vein was observed in routine upper limb dissection. This case report presents variation in the course of left cephalic vein and its abnormal communication with the subclavian vein.
Conclusion: Although the supraclavicular course of the cephalic vein is a rare anatomical variant, the knowledge of variations in the origin, course and termination of cephalic vein is important for surgeons, radiologists, and plastic surgeons. It is a preferred vein for suitable central venous access, pacemaker and defibrillator implantation. Further, the normal anatomy of cephalic vein, including its anatomical variation is paramount to avoid complications.

Keywords: Pacemaker, Subclavian vein, Supraclavicular cephalic vein