Introduction The prevalence and clinical significance of fetal posterior cerebral artery (FPCA) variants are studied using magnetic resonance imaging (MRI) at Saveetha Medical College. This research focuses on the fetal origin of the posterior cerebral artery (PCA), a condition where the posterior communicating artery (PComA) is larger than the P1 segment of the PCA, affecting cerebral hemodynamics and associated with various cerebrovascular pathologies. Materials and methods This retrospective analysis employed MRI records from the Department of Radio Diagnosis at Saveetha Medical College, conducted between January 2013 and December 2023. The study included patients undergoing MRI for various neurological indications, with specific imaging protocols including T1- and T2-weighted sequences, diffusion-weighted imaging, and magnetic resonance angiography (MRA). Results The study confirmed a prevalence rate of FPCA variants within the expected range of 20%-30%. MRI findings were systematically analyzed by experienced radiologists to assess the presence and characteristics of FPCA variants. The relationship between these variants and clinical symptoms was explored, revealing significant correlations that emphasize the variants' impact on patient outcomes, particularly in the context of cerebrovascular events. Conclusion The study underlines the importance of recognizing FPCA variants due to their significant implications in neurovascular health and cerebrovascular accident (CVA) outcomes. These variants alter cerebral hemodynamics and can complicate neurosurgical and diagnostic procedures. Therefore, personalized treatment and management strategies are crucial for optimizing patient care.Introduction The prevalence and clinical significance of fetal posterior cerebral artery (FPCA) variants are studied using magnetic resonance imaging (MRI) at Saveetha Medical College. This research focuses on the fetal origin of the posterior cerebral artery (PCA), a condition where the posterior communicating artery (PComA) is larger than the P1 segment of the PCA, affecting cerebral hemodynamics and associated with various cerebrovascular pathologies. Materials and methods This retrospective analysis employed MRI records from the Department of Radio Diagnosis at Saveetha Medical College, conducted between January 2013 and December 2023. The study included patients undergoing MRI for various neurological indications, with specific imaging protocols including T1- and T2-weighted sequences, diffusion-weighted imaging, and magnetic resonance angiography (MRA). Results The study confirmed a prevalence rate of FPCA variants within the expected range of 20%-30%. MRI findings were systematically analyzed by experienced radiologists to assess the presence and characteristics of FPCA variants. The relationship between these variants and clinical symptoms was explored, revealing significant correlations that emphasize the variants' impact on patient outcomes, particularly in the context of cerebrovascular events. Conclusion The study underlines the importance of recognizing FPCA variants due to their significant implications in neurovascular health and cerebrovascular accident (CVA) outcomes. These variants alter cerebral hemodynamics and can complicate neurosurgical and diagnostic procedures. Therefore, personalized treatment and management strategies are crucial for optimizing patient care.