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The development of the nervous system is a complex process that begins early in embryogenesis and continues to evolve throughout life. Variations in nerve supply, originating from embryological changes, play a crucial role in both normal physiology and the manifestation of neurological disorders. This review explores the embryological origins of nerve supply and how these developmental variations influence nerve function and clinical outcomes. We examine the fundamental stages of neural development, including the formation of the neural tube, the differentiation of neural crest cells, and the establishment of peripheral nerve patterns. The review highlights how deviations in these processes can lead to variations in nerve supply, affecting both structure and function. We discuss common and rare embryological variations and their implications for surgical interventions, diagnostic practices, and treatment strategies. By integrating insights from developmental biology with clinical observations, this review provides a comprehensive understanding of how embryological factors shape nerve supply and contribute to diverse neurological conditions. Our aim is to enhance awareness of these developmental variations and to inform strategies for managing their clinical impacts.