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The Superior Thyroid Artery (STA) is the dominant arterial supply of the thyroid gland, larynx and the neck. Awareness of variations in STA is crucial for invasive operations in the neck region. We reported a case that STA derives from the Common Carotid Artery (CCA). A patient with possible transient ischemic attack had an digital substraction angiography. Angiography revealed superior thyroid artery derived from the common carotid artery in the left.