Background: Aortic arch and vertebral artery anomalies are vascular variations that occur as a result of embryological developmental defects. Bicarotid trunk anomaly is a rare aortic arch anomaly and refers to a common single trunk origin of common carotid arteries. VA origin anomalies are mostly unilateral and the most common is the LVA originating from the aortic arch. Abnormal origin of the RVA from the RCCA is a rare vascular anomaly. In this case, we presented ARSA and bicarotid trunk anomaly with abnormal origin of the vertebral arteries. Case presentation: A 64-year-old male was admitted to our center with complaints of chronic headache and dizziness. In addition to ARSA and bicarotid trunk anomaly, RVA originating from RCCA and LVA originating from aortic arch were observed in CT angiography. The origin of LVA was between the bicarotid trunk and LSCA. Both VA were entering the transverse foramen at the level of the C6 vertebra. These anomalies were also revealed in detail by MR angiography of head/neck. Conclusion: Aortic arch anomalies are a group with different subtypes. Awareness of VA origin anomalies is important for planning surgical and endovascular interventional procedures.