Background: Posterior inferior cerebellar artery and its branches supply extensive and vital areas of the nervous system. This vessel is reported as the most variable cerebellar artery in the literature. The knowledge of normal anatomy as well as variations in this artery is of utmost importance to help diagnosis and treatment of vascular lesions as well as space occupying lesions in the region of its distribution. Aims and Objectives: To study the normal gross anatomy and development of posterior inferior cerebellar artery, with incidence of variations and their embryological correlation. Materials & Methods: The posterior inferior cerebellar artery was studied by digital subtraction angiography. The procedure of digital subtraction angiography was performed in Department of Radiology of a tertiary care hospital of Mumbai in 102 consecutive subjects on both sides. Results: A significant number of variations were observed in origin, course and distribution of the posterior inferior cerebellar artery in this study. Conclusion: This study confirms as well as adds to the knowledge of the existing literature on posterior inferior cerebellar artery and assists interventional radiologist, neurosurgeons and neurologist in diagnosis and treatment of cerebrovascular diseases.